Active NPI
Syed Yousuf Khadri, M.D.
- Psychiatry Physician
- Willow Brook, IL
National Provider Identifier
1154377836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Practice address
- 621 Plainfield Rd
Suite 110
Willow Brook, IL 60527-5343 - Phone
- (630) 325-1799
- Fax
- (630) 325-1882
- NPI assigned
- May 25, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
621 Plainfield Rd
Suite 110
Willow Brook, IL 60527-5343
Mailing address
621 Plainfield Rd
Suite 110
Willow Brook, IL 60527-5343
Phone (630) 325-1799
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336040080 | IL | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Accounts Receivable Management Team | Psychiatry | Past | Accepting new patients |
| Pilsen Medical Clinic & Associates, LLC | Past | Accepting new patients | |
| Elite Community Mental Health Center | Past | Accepting new patients | |
| Hamdard Health Alliance | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/17656/brand/1/csg/1/fhir/r4
Organizations & group practices 5
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.
-
- Psychiatry Physician
- Warrenville, IL
- NPI 1053355289
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1194779181
-
- Federally Qualified Health Center (FQHC)
- Bensenville, IL
- NPI 1700470580
-
- Family Medicine Physician
- Elmhurst, IL
- NPI 1790039725
-
- Psychiatry Physician
- Homewood, IL
- NPI 1881760353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1154377836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 PLAINFIELD RD",
"address_2": "SUITE 110",
"city": "WILLOW BROOK",
"state": "IL",
"postal_code": "605275343",
"telephone_number": "630-325-1799",
"fax_number": "630-325-1882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 PLAINFIELD RD",
"address_2": "SUITE 110",
"city": "WILLOW BROOK",
"state": "IL",
"postal_code": "605275343",
"telephone_number": "630-325-1799",
"fax_number": "630-325-1882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHADRI",
"first_name": "SYED",
"middle_name": "YOUSUF",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willow Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.