Individual provider Active NPI

Nadeem Hanif, M.D.

  • Pulmonary Disease Physician
  • Rockford, IL
National Provider Identifier
1972617181
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036 091943 Issued in IL
Practice address
535 Roxbury Rd
Suite B600
Rockford, IL 61107-5076
Phone
(815) 397-7212
Fax
(815) 397-2539
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036 091943 IL Primary

Addresses

Primary practice location

535 Roxbury Rd
Suite B600
Rockford, IL 61107-5076

Mailing address

535 Roxbury Rd
Suite B600
Rockford, IL 61107-5076
Phone (815) 397-7212

Other identifiers 3

IdentifierTypeStateIssuer
036 091943MedicaidIL
101 32066OtherILBLUE CROSS BLUE SHIELD
P00001224OtherILRAILROAD MEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070629000174 IL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5597864793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

535 Roxbury Rd
Rockford, IL 61107-5076
Phone (815) 387-1717

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
  • Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312
  • FHN Memorial Hospital Hospital, Freeport, IL, CCN 140160

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036 091943ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince May 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
KSB Medical Group, Inc. Past Accepting new patients
KSB Medical Group, Inc. Past Accepting new patients

Locations

215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

5668 E State St
Ste B600
Rockford, IL 61108
Phone (815) 397-7212

535 Roxbury Rd
Ste B600
Rockford, IL 61107
Phone (815) 397-7212

444 Roxbury Rd
#12471
Rockford, IL 61107

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

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.

Hospital & facility affiliations 5

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1972617181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "address_2": "SUITE B600",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-397-7212",
            "fax_number": "815-397-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "address_2": "SUITE B600",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-397-7212",
            "fax_number": "815-397-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANIF",
        "first_name": "NADEEM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036 091943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036 091943",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "101 32066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00001224",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.