NPIMap

Individual provider Active NPI

Nausheen Zainab Khan, PA

  • Medical Physician Assistant
  • Skokie, IL
National Provider Identifier
1205138617
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.003948 Issued in IL
Practice address
4453 Main St
Skokie, IL 60076-2030
Phone
(773) 756-8064
NPI assigned
Nov 18, 2010
Last updated
Nov 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.003948 IL Primary

Addresses

Primary practice location

4453 Main St
Skokie, IL 60076-2030

Mailing address

4453 Main St
Skokie, IL 60076-2030
Phone (773) 756-8064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110516000787 IL Practitioner - Physician Assistant 5092991687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Group LTDGroup PAC ID 1153585658, 7 clinicians

Practice addresses (Care Compare)

4419 W 95TH St
Oak Lawn, IL 60453-7223
Phone (708) 576-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.003948ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Pulmonary Critical Care & Sleep Consultants LLC PastSince May 1, 2018 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients
24 Ihim LLC PastSince Jul 25, 2019 Accepting new patients
Faminamed Healthcare Providers SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nkhan283731@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1205138617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4453 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762030",
            "telephone_number": "773-756-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4453 MAIN ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762030",
            "telephone_number": "773-756-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NAUSHEEN",
        "middle_name": "ZAINAB",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.