Individual provider Active NPI

Syed Yousuf Khadri, M.D.

  • Psychiatry Physician
  • Willow Brook, IL
National Provider Identifier
1154377836
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
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

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000053 IL Practitioner - Psychiatry 7618932120 Reassigns benefits to 1 organization

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
336040080ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.