Active NPI
Fida Bachour, MD
- Internal Medicine Physician
- Lombard, IL
National Provider Identifier
1962439927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Practice address
- 875 E 22ND St
Unit 428
Lombard, IL 60148-5013 - Phone
- (630) 268-1886
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Primary |
Addresses
Primary practice location
875 E 22ND St
Unit 428
Lombard, IL 60148-5013
Mailing address
875 E 22ND St
Unit 428
Lombard, IL 60148-5013
Phone (630) 268-1886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130628000431 | IL | Order and Referring Only - Internal Medicine | 0143121871 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036108758 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Women'S Doc of Elgin, S. C. | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188864000000",
"number": "1962439927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 E 22ND ST",
"address_2": "UNIT 428",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601485013",
"telephone_number": "630-268-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 E 22ND ST",
"address_2": "UNIT 428",
"city": "LOMBARD",
"state": "IL",
"postal_code": "601485013",
"telephone_number": "630-268-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACHOUR",
"first_name": "FIDA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2007-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lombard, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.