Individual provider Active NPI

Henna Khan, MD

  • Internal Medicine Physician
  • Decatur, IL
National Provider Identifier
1124760509
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036174211 Issued in IL
Practice address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone
(217) 464-2966
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036174211 IL Primary

Addresses

Primary practice location

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Mailing address

8907 188TH St
Hollis, NY 11423-1914
Phone (347) 935-6757

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251023001565 IL Practitioner - Internal Medicine 0446637060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-2966

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036174211ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists CurrentSince Aug 26, 2025 Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine Current Accepting new patients
Cep America-Illinois Hospitalists, LLP Internal Medicine CurrentSince Aug 26, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1124760509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8907 188TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231914",
            "telephone_number": "347-935-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HENNA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036174211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.