Active NPI
Ulfat Sanam Khan
- Optometrist
- Arlington Heights, IL
National Provider Identifier
1124322417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-010414
- Practice address
- 704 E Rand Rd
Arlington Heights, IL 60004-4006 - Phone
- (847) 259-3933
- NPI assigned
- Jan 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046-010414 | IL | Primary |
Addresses
Primary practice location
704 E Rand Rd
Arlington Heights, IL 60004-4006
Mailing address
1631 N 5TH Ave
Melrose Park, IL 60160-2403
Phone (708) 369-7835
Medicare participation
Medicare enrollment files- 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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-010414 | IL | MD | Optometrist |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1124322417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 N 5TH AVE",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601602403",
"telephone_number": "708-369-7835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 E RAND RD",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600044006",
"telephone_number": "847-259-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "ULFAT",
"middle_name": "SANAM",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-01",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-010414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.