Individual provider Active NPI

Atif Khan

  • Anesthesiology Physician
  • Geneva, IL
National Provider Identifier
1144752627
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036161545 Issued in IL
Practice address
300 Randall Rd
Geneva, IL 60134-4200
Phone
(630) 208-4060
Fax
(630) 208-4401
NPI assigned
Apr 3, 2017
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X OP61163649 WA
Anesthesiology Physician 207L00000X 036161545 IL Primary

Addresses

Primary practice location

300 Randall Rd
Geneva, IL 60134-4200

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

325 9th Ave
Seattle, WA 98104-2420
Phone (206) 520-5000

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
I20220919001764 IL Practitioner - Anesthesiology 2365846250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Randall Rd
FL 1
Geneva, IL 60134-4200
Phone (630) 208-4060

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036161545ILMDAnesthesiology Physician
OP61163649WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

300 Randall Rd
Fl 1
Geneva, IL 60134
Phone (630) 208-4060

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

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.

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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1144752627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-208-4060",
            "fax_number": "630-208-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042420",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ATIF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP61163649",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036161545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.