Individual provider Active NPI

Ahmed Ali Khan

  • Hospitalist Physician
  • Rockford, IL
National Provider Identifier
1275268369
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.173114 Issued in IL
Practice address
1221 E State St
Rockford, IL 61104-2231
Phone
(815) 972-1037
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125.080223 IL
Hospitalist Physician 208M00000X 036.173114 IL Primary

Addresses

Primary practice location

1221 E State St
Rockford, IL 61104-2231

Mailing address

1221 E State St
Rockford, IL 61104-2231
Phone (815) 972-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khanmd@uic.edu

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409000700 IL Practitioner - Hospitalist 4486037322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Hospitalist Group LLCGroup PAC ID 9830559491, 41 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.173114ILMDHospitalist Physician
125.080223ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Hospitalist Group, LLC Hospitalist CurrentSince Apr 1, 2025 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1625 S State St
Belvidere, IL 61008
Phone (815) 544-1846

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

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 2

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1275268369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AHMED",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.080223",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.173114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khanmd@uic.edu",
            "affiliation": "N",
            "address_1": "1221 E State St",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611042231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.