Organization Active NPI

Fairview Ogden Medical Group LTD.

  • Internal Medicine Physician
  • Downers Grove, IL
National Provider Identifier
1962683359
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-091132 Issued in IL
Legal business name
FAIRVIEW OGDEN MEDICAL GROUP LTD.
Practice address
4121 Fairview Ave Ste L1
Downers Grove, IL 60515-2265
Phone
(630) 968-4790
Fax
(630) 968-8755
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Zainulabuddin SyedNPI 1609876424
Title
Owner
Phone
(630) 968-4790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 036-091132 IL Primary

Addresses

Primary practice location

4121 Fairview Ave Ste L1
Downers Grove, IL 60515-2265

Mailing address

4121 Fairview Ave Ste L1
Downers Grove, IL 60515-2265
Phone (630) 968-4790

Other identifiers 2

IdentifierTypeStateIssuer
036091132MedicaidIL
1609876424OtherINDIVIDUAL NPI

Other names 1

  • Fairview Ogden Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101129000120 IL Part B Supplier - Clinic/Group Practice 2567658891 Receives reassigned benefits from 2 practitioners
Practice locations: Downers Grove, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0982074Fairview Ogden Medical Group4121 Fairview Avenue Suite L1, Downers Grove, IL 60515Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1962683359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE STE L1",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152265",
            "telephone_number": "630-968-4790",
            "fax_number": "630-968-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE STE L1",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152265",
            "telephone_number": "630-968-4790",
            "fax_number": "630-968-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW OGDEN MEDICAL GROUP LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "ZAINULABUDDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-968-4790"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-091132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091132",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1609876424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairview Ogden Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.