Individual provider Active NPI

Mohemad Rizwan Khaleel, M.D.

  • Emergency Medicine Physician
  • Calumet City, IL
National Provider Identifier
1265627400
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036119244 Issued in IL
Practice address
1600 Torrence Ave
Suite a
Calumet City, IL 60409-5430
Phone
(708) 891-0089
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036119244 IL
Emergency Medicine Physician 207P00000X 036119244 IL Primary

Addresses

Primary practice location

1600 Torrence Ave
Suite a
Calumet City, IL 60409-5430

Mailing address

100 Forest TRL
Oak Brook, IL 60523-1411
Phone (630) 854-6683

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
I20071101000639 IL Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 6002903432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 167TH St
Suite 250
Calumet City, IL 60409-5484
Phone (708) 891-0089

Hospital & facility affiliations

  • Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHAIBA/Endpoint/JHAIBA

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1265627400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FOREST TRL",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231411",
            "telephone_number": "630-854-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 TORRENCE AVE",
            "address_2": "SUITE A",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095430",
            "telephone_number": "708-891-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEEL",
        "first_name": "MOHEMAD",
        "middle_name": "RIZWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119244",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036119244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

Verify at the official NPI Registry.