Individual provider Active NPI

Maliha Khan, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1013527043
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.032598 Issued in IL
Practice address
5961 N Lincoln Ave
Chicago, IL 60659-3758
Phone
(847) 814-1831
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032598 IL Primary

Addresses

Primary practice location

5961 N Lincoln Ave
Chicago, IL 60659-3758

Mailing address

2729 W Jerome St
Chicago, IL 60645-1304
Phone (847) 814-1831

Other practice location 1

2729 W Jerome St
Chicago, IL 60645-1304
Phone (847) 814-1831

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
I20221004003540 IL Practitioner - Dentist 0547646176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles (1 of 4)

OrganizationSpecialtyStatusNew patients
Espoir Lab Inc CurrentSince Aug 14, 2022 Accepting new patients

Locations

6257 N Clark St
Chicago, IL 60660
Phone (773) 508-1927

Networks

  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

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": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1013527043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2729 W JEROME ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451304",
            "telephone_number": "847-814-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5961 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593758",
            "telephone_number": "847-814-1831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2729 W Jerome St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606451304",
            "country_code": "US",
            "telephone_number": "847-814-1831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MALIHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.