NPIMap

Individual provider Active NPI

Mohammad Vaseemuddin, M.D.

  • Internal Medicine Physician
  • Addison, IL
National Provider Identifier
1952453995
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-110447 Issued in IL
Practice address
240 E Lake St Ste 102
Addison, IL 60101-2873
Phone
(630) 782-9780
Fax
(630) 782-9781
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036-110447 IL
Internal Medicine Physician 207R00000X 036-110447 IL Primary

Addresses

Primary practice location

240 E Lake St Ste 102
Addison, IL 60101-2873

Mailing address

240 E Lake St Ste 102
Addison, IL 60101-2873
Phone (630) 782-9780

Other practice location 1

425 Ogden Ave
Downers Grove, IL 60515-3066
Phone (630) 876-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000107 IL Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - NephrologyPractitioner - Emergency Medicine 4789625542 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine, Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haris Medical Group LLCGroup PAC ID 1254633290, 2 clinicians

Practice addresses (Care Compare)

1252 Ogden Ave
Suite a
Downers Grove, IL 60515-2740
Phone (630) 782-9780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-110447ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairoaks Medical LLC Internal Medicine CurrentSince Oct 18, 2014 Accepting new patients
Haris Medical Group LLC Internal Medicine CurrentSince Dec 11, 2015 Accepting new patients
Cook County Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Jan 1, 2005 Accepting new patients
West Northwest Suburban Community Health Center Internal Medicine CurrentSince Sep 16, 2022 Accepting new patients
Home Dialysis & Kidney Care Limited Internal Medicine Past Accepting new patients
Hoscon LTD Nephrology Past Accepting new patients
Afmc Vendor Services LLC Nephrology PastSince Dec 15, 2024 Accepting new patients

Locations

240 E Lake St
Ste 102
Addison, IL 60101
Phone (630) 272-4129

1131 S Arlington Heights Rd
Ste C
Arlington Heights, IL 60005
Phone (630) 782-9780

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

425 Ogden Ave
Downers Grove, IL 60515
Phone (630) 506-5553

1252 Ogden Ave
Ste D
Downers Grove, IL 60515
Phone (630) 876-9000

1252 Ogden Ave
Downers Grove, IL 60515
Phone (630) 876-9000

1252 Ogden Ave
Ste B
Downers Grove, IL 60515
Phone (630) 847-7880

1252 Ogden Ave
Ste A
Downers Grove, IL 60515
Phone (630) 782-9780

1634 S Ardmore Ave
Villa Park, IL 60181
Phone (630) 620-1233

760 Pasquinelli Dr
Ste 300B
Westmont, IL 60559
Phone (630) 782-9780

Organizations & group practices 10

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1952453995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E LAKE ST STE 102",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012873",
            "telephone_number": "630-782-9780",
            "fax_number": "630-782-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E LAKE ST STE 102",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012873",
            "telephone_number": "630-782-9780",
            "fax_number": "630-782-9781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Ogden Ave",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605153066",
            "country_code": "US",
            "telephone_number": "630-876-9000",
            "fax_number": "630-876-9004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASEEMUDDIN",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036-110447",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-110447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.