Individual provider Active NPI

Mona Khan, D.O.

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1073820775
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036150802 Issued in IL
Practice address
520 N Michigan Ave Ste 225
Chicago, IL 60611-6989
Phone
(312) 772-5623
NPI assigned
Sep 2, 2010
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036150802 IL
Obstetrics & Gynecology Physician 207V00000X 036150802 IL Primary

Addresses

Primary practice location

520 N Michigan Ave Ste 225
Chicago, IL 60611-6989

Mailing address

520 N Michigan Ave Ste 225
Chicago, IL 60611-6989
Phone (312) 772-5623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205000671 IL Practitioner - Obstetrics/GynecologyPractitioner - Family Practice 0244663235

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036150802ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
2001-15 N Parkside LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

405 N Wabash Ave
Ste P2-A
Chicago, IL 60611
Phone (312) 955-4005

Interoperability endpoints

  • Direct secure messaging: mkhando371612@carlehiedirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1073820775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MICHIGAN AVE STE 225",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116989",
            "telephone_number": "312-772-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MICHIGAN AVE STE 225",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116989",
            "telephone_number": "312-772-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MONA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036150802",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036150802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.