RUBA AZZAM – Pediatric Gastroenterology Physician, NPI 1356491385
Pediatric Gastroenterology Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for RUBA AZZAM
5841 S MARYLAND AVE # MC1099
MC 4065
CHICAGO, IL 606371447
Phone: (773) 702-6418
Fax: (773) 702-0666
Type: Mailing
150 HARVESTER DR
SUITE 300
BURR RIDGE, IL 605275919
Phone:
Type: Mailing
5841 S MARYLAND AVE
CHICAGO, IL 606371443
Phone: (888) 824-0200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $55.
Total Amount is formed as General ($55) + Research ($0) + Ownership ($0) = $55.
Last reported payment date: 2024-02-09 • Largest payer in this snapshot: Medtronic, Inc. ($23).
Total Amount
$55
General + Research + Ownership
Payments
3
Total payment records
General Amount
$55
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $23 |
| Mirum Pharmaceuticals, Inc. | $17 |
| NESTLE HEALTHCARE NUTRITION INC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-08-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051024000119 | I | Pediatric Medicine | IL | TBD |
| I20210831001648 | I | Pediatric Medicine | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60637)
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