Physician Compare National (NPI:1255532784)

HEALTHCARE PROVIDER: JAVERIA SHAHEEN QURESHI MD MPH

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255532784
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052536331
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150925001832
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	QURESHI
	Individual professional last name
Provider First Name	JAVERIA
	Individual professional first name
Provider Middle Name	SHAHEEN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	OSF MULTI-SPECIALTY GROUP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	3678889789
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	1247
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5668 E STATE ST
	Group Practice or individual's line 1 address
City	ROCKFORD
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	611082464
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8153977900
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140233
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OSF SAINT ANTHONY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140160
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FHN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	160057
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GREAT RIVER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140155
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	PRESENCE ST MARYS HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y