Individual provider Active NPI

Shahana Khan, RD

  • Registered Dietitian
  • Naperville, IL
National Provider Identifier
1003683764
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164003128 Issued in IL
Practice address
1415 Hobson Rd
Naperville, IL 60540-9428
Phone
(630) 926-6654
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164003128 IL Primary

Addresses

Primary practice location

1415 Hobson Rd
Naperville, IL 60540-9428

Mailing address

1415 Hobson Rd
Naperville, IL 60540-9428
Phone (630) 926-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
164003128ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Organizations & group practices 1

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": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1003683764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HOBSON RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409428",
            "telephone_number": "630-926-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 HOBSON RD",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605409428",
            "telephone_number": "630-926-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHANA",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164003128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.