Nala Al-Khatib, MD

Individual provider Active NPI Pediatrics Physician · Chicago, IL

NPI 1053988931 · NPPES record last updated Jul 10, 2025

Key facts

NPI
1053988931
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
125.085726 (IL)
Practice address
1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227
Phone
(312) 942-2200
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250715001003 IL Order and Referring Only - Pediatric Medicine
Practitioner - Pediatric Medicine
8628583093

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.085726ILMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL
Pediatrics Physician 208000000X 125.085726 IL Yes

Addresses

Primary practice location

1645 W Jackson Blvd Ste 200
Chicago, IL 60612-3227

Mailing address

600 S Paulina St Ste 403
Chicago, IL 60612-3806

Other providers in Chicago, IL

All providers in Chicago, IL · Pediatrics Physician in Illinois

Sources for this page

Verify at the official NPI Registry.