Individual provider Active NPI

Abdul Khan, PHARMD

  • Pharmacist
  • Olympia Fields, IL
National Provider Identifier
1083234140
Registry record updated Apr 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051299300 Issued in IL
Practice address
21000 Western Ave
Olympia Fields, IL 60461-1935
Phone
(708) 898-9114
NPI assigned
Apr 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051299300 IL Primary

Addresses

Primary practice location

21000 Western Ave
Olympia Fields, IL 60461-1935

Mailing address

323 Arboretum Dr
Lombard, IL 60148-7111
Phone (630) 890-6748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051299300ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587254400000",
    "number": "1083234140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 ARBORETUM DR",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487111",
            "telephone_number": "630-890-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 WESTERN AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611935",
            "telephone_number": "708-898-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABDUL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-19",
        "last_updated": "2020-04-19",
        "certification_date": "2020-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051299300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.