NPIMap

Organization Active NPI

Devon Homecare Physicians Inc.

  • Adult Medicine Physician
  • Chicago, IL
National Provider Identifier
1043811425
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
DEVON HOMECARE PHYSICIANS INC.
Practice address
2822 W. Granville Ave. Apt 1
Chicago, IL 60659
Phone
(872) 806-3340
NPI assigned
Nov 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Authorized official

Name
Mohammed J Khan, M.D
Title
President
Phone
(872) 806-3340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

2822 W. Granville Ave. Apt 1
Chicago, IL 60659

Mailing address

2822 W. Granville Ave. Apt 1
Chicago, IL 60659
Phone (872) 806-3340

Other identifiers 1

IdentifierTypeStateIssuer
036109208MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1043811425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2822 W. GRANVILLE AVE. APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "872-806-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2822 W. GRANVILLE AVE. APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "872-806-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVON HOMECARE PHYSICIANS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "872-806-3340",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.