Audisho Brimo Khoshaba, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036078916 Issued in IL

Practice address

2653 W Peterson Ave
Chicago, IL 60659-4017

Phone

(773) 728-9399

Fax

(773) 728-4162

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lyfe Home Health Home health agency, Morton Grove, IL, CCN 148044
• Residential Home Health Home health agency, Northbrook, IL, CCN 147001
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Abk Medical Center, LTD.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1720263197
  Medicare reassignment NPD Authorized official
• Sushil K Sharma MD SC

  • Cardiovascular Disease Physician
  • Skokie, IL
  • NPI 1346563921
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Four Seasons Home Healthcare, Inc.

  • Home Health Registered Nurse
  • Morton Grove, IL
  • NPI 1194808402

  Home health agency

  Care Compare affiliation
• Residential Home Health Illinois, LLC

  • Home Health Agency
  • Northbrook, IL
  • NPI 1114673787
  Care Compare affiliation
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1104933191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594017",
            "telephone_number": "773-728-9399",
            "fax_number": "773-728-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594017",
            "telephone_number": "773-728-9399",
            "fax_number": "773-728-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHABA",
        "first_name": "AUDISHO",
        "middle_name": "BRIMO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036078916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Alexandria Khorasanee, M.D.
• Arjang Khorasani, MD
• Zahra Khorrami, DDS
• Elizaveta Khoryev, MD
• Hazel Khosa, MBBS
• Edena Khoshaba
• Margaret Hensley Khoshaba
• Sargiss Khoshaba
• Nasim Khoshfetrat, DMD
• Reza J Khoshnood, D.M.D.

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.