Ayesha Ali, MD
Individual provider Active NPI Family Medicine Physician · Glenview, IL
NPI 1962453456 · NPPES record last updated Nov 14, 2022
Key facts
- NPI
- 1962453456
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036087496 (IL)
- Practice address
- 2701 Patriot Blvd Ste 110
Glenview, IL 60026-8039 - Phone
- (312) 694-2273
- Fax
- (847) 998-9833
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwestern Medical Faculty Foundation
Practice addresses (Care Compare)
2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 724-4536
Hospital & facility affiliations
- Northwestern Memorial Hospital
- Northwestern Lake Forest Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040607000968 | IL | Practitioner - Family Practice | 4183606619 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036087496 | IL | MD | Family Medicine Physician |
| 01077801A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| County of Lake | Current |
Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current |
Accepting new patients | |
| County of Lake | Current | Accepting new patients | |
| County of Lake | Current |
Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
2701 Patriot Blvd
Ste 110
Glenview, IL 60026
Phone (312) 694-2273
2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
224 W Clarendon Dr
Round Lake Beach, IL 60073
Phone (847) 377-8800
2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400
3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036087496 | IL | |
| Family Medicine Physician | 207Q00000X | 01077801A | IN | |
| Family Medicine Physician | 207Q00000X | 036087496 | IL | Yes |
Addresses
Primary practice location
2701 Patriot Blvd Ste 110
Glenview, IL 60026-8039
Mailing address
2701 Patriot Blvd Ste 110
Glenview, IL 60026-8039
Phone (312) 694-2273
Other practice location 1
5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 828-8200
Other practice location 2
5550 S East St Ste C
Indianapolis, IN 46227-1991
Phone (317) 534-4660
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201410780 | Medicaid | IN |
Other providers in Glenview, IL
- Anthony Matanios Aldurra
- Sarah Alexander
- Tatiana Alexeev
- Hassan Alhiti
- Ali Nematollahi D.D.S., P.C.
- Sofia Ali
- Diane Alkatout
- All Care Home Health Care Inc
- All Care Home Physicians, S. C.
- Abigail Michele Allen
All providers in Glenview, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.