Individual provider Active NPI

Yousaf Hasan Ahmad, D.D.S

  • General Practice Dentistry
  • Elgin, IL
National Provider Identifier
1972865491
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019030102 Issued in IL
Practice address
2415 Bowes Rd Ste 110
Elgin, IL 60123-5535
Phone
(847) 386-4300
Fax
(847) 686-3622
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2012017871 MO
General Practice Dentistry 1223G0001X 019030102 IL Primary

Addresses

Primary practice location

2415 Bowes Rd Ste 110
Elgin, IL 60123-5535

Mailing address

2415 Bowes Rd Ste 110
Elgin, IL 60123-5535
Phone (847) 386-4300

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505002930 IL Practitioner - Dentist 8325479454 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012017871MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partnership of Illinois Current Accepting new patients
Community Health Partnership of Illinois CurrentSince Apr 1, 2020 Accepting new patients
Community Health Partnership of Illinois CurrentSince Apr 1, 2020 Accepting new patients
Yousaf Ahmad DDS LLC General Practice Past Accepting new patients

Locations

157 S Lincoln Ave
Ste D
Aurora, IL 60505
Phone (630) 859-0015

205 W Randolph St
Ste 2222
Chicago, IL 60606
Phone (312) 795-0000

1009 Main St
Mendota, IL 61342
Phone (312) 795-0000

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.

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1972865491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 BOWES RD STE 110",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235535",
            "telephone_number": "847-386-4300",
            "fax_number": "847-686-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 BOWES RD STE 110",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235535",
            "telephone_number": "847-386-4300",
            "fax_number": "847-686-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMAD",
        "first_name": "YOUSAF",
        "middle_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012017871",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.