Organization Active NPI

Ahk Surgical S.C.

  • Surgery Physician
  • Evergreen Park, IL
National Provider Identifier
1053509448
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
AHK SURGICAL S.C.
Practice address
2850 W 95TH St
Evergreen Park, IL 60805-2735
Phone
(708) 636-4116
Fax
(708) 636-5346
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Adbul Haye Khan, M.D.
Title
Owener
Phone
(708) 636-4116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X IL Primary

Addresses

Primary practice location

2850 W 95TH St
Evergreen Park, IL 60805-2735

Mailing address

PO Box 248
Worth, IL 60482-0248
Phone (708) 532-5660

Other identifiers 1

IdentifierTypeStateIssuer
0021608752OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Abdul Haye Khan Doing business as

National Provider Directory

National Provider Directory

Locations

2850 W 95th St
Ste 102
Evergreen Pk, IL 60805
Phone (708) 422-6200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1053509448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604820248",
            "telephone_number": "708-532-5660",
            "fax_number": "708-532-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-636-4116",
            "fax_number": "708-636-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHK SURGICAL S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ADBUL",
        "authorized_official_middle_name": "HAYE",
        "authorized_official_title_or_position": "OWENER",
        "authorized_official_telephone_number": "708-636-4116",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0021608752",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abdul Haye Khan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.