Organization Active NPI

N M Khan M D S C

  • Specialist
  • Palos Heights, IL
National Provider Identifier
1164636585
Registry record updated Jun 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
N M KHAN M D S C
Practice address
7600 W College Dr
2ND Floor
Palos Heights, IL 60463-1001
Phone
(708) 671-1800
Fax
(708) 671-1803
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2012

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

Authorized official

Name
Noorun Khan, MDNPI 1548234073
Title
Owner
Phone
(630) 244-2841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7600 W College Dr
2ND Floor
Palos Heights, IL 60463-1001

Mailing address

PO Box 393
Worth, IL 60482-0393
Phone (630) 551-1097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070924000238 IL Part B Supplier - Clinic/Group Practice 9739273640 Receives reassigned benefits from 3 practitioners
Practice locations: Lemont, IL; New Lenox, IL; Glendale Heights, IL; Oak Lawn, IL; Palos Heights, IL; Sandwich, IL; Winfield, IL; Yorkville, IL…

National Provider Directory

National Provider Directory

Locations

6234 S Narragansett Ave
Chicago, IL 60638
Phone (773) 586-3456

11950 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-9450

234 Garden St
#A
Yorkville, IL 60560
Phone (630) 820-7045

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339200000000",
    "number": "1164636585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 393",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604820393",
            "telephone_number": "630-551-1097",
            "fax_number": "630-551-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 W COLLEGE DR",
            "address_2": "2ND FLOOR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631001",
            "telephone_number": "708-671-1800",
            "fax_number": "708-671-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N M KHAN M D S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2012-06-09",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NOORUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-244-2841",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.