Individual provider Active NPI

El-Waleed Mohammed Ali

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1942608252
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
201402094 Issued in NC
Practice address
5841 S Maryland Ave # Mc1027
Chicago, IL 60637
Phone
(773) 702-7936
NPI assigned
Dec 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2014-02094 NC
Hypertension Specialist Physician 207RH0005X 036.145875 IL
Hospitalist Physician 208M00000X 2014-02094 NC
Internal Medicine Physician 207R00000X 201402094 NC Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc1027
Chicago, IL 60637

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150406000145 NC Practitioner - Internal Medicine 1850619768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201402094NCMDInternal Medicine Physician
036.145875ILMDHypertension Specialist Physician
2014-02094NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc Current Accepting new patients
Bladen Healthcare LLC Current Accepting new patients
Bladen Healthcare, LLC Hospitalist CurrentSince Oct 1, 2022 Accepting new patients
Bladen Healthcare LLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

210 Medical Pavilion Dr
Raeford, NC 28376
Phone (910) 904-8000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1942608252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC1027",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-7936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMED ALI",
        "first_name": "EL-WALEED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2014-02094",
            "primary": false
        },
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "IL",
            "license": "036.145875",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2014-02094",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201402094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.