Individual provider Active NPI

Amir Islam Khan, PA

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1316207111
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085002448 Issued in IL
Practice address
5600 W Addison St Lowr 1LL
Chicago, IL 60634-4444
Phone
(773) 202-9622
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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 085002448 IL Primary

Addresses

Primary practice location

5600 W Addison St Lowr 1LL
Chicago, IL 60634-4444

Mailing address

5600 W Addison St Lowr 1LL
Chicago, IL 60634-4444
Phone (773) 202-9622

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406000082 IL Practitioner - Physician Assistant 0042267635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Healthcare Partners PLLCGroup PAC ID 2466824149, 25 clinicians
Metropolitan Gericare Associates PLLCGroup PAC ID 3577093657, 10 clinicians

Practice addresses (Care Compare)

3445 N Central Ave
Chicago, IL 60634-4420
Phone (773) 205-0800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Gericare Associates PLLC CurrentSince Feb 1, 2026 Accepting new patients
Northwest Medical Center S.C. Past Accepting new patients
Advanced Cancer Clinic LTD PastSince Nov 22, 1996 Accepting new patients

Locations

5600 W Addison St
Lowr 1LL
Chicago, IL 60634
Phone (773) 202-9622

3445 N Central Ave
Chicago, IL 60634
Phone (312) 715-8088

3445 N Central Ave
Ste C
Chicago, IL 60634
Phone (773) 205-0800

3445 N Central Ave
Unit C
Chicago, IL 60634
Phone (773) 205-0800

Organizations & group practices 4

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1316207111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST LOWR 1LL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344444",
            "telephone_number": "773-202-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 W ADDISON ST LOWR 1LL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344444",
            "telephone_number": "773-202-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AMIR",
        "middle_name": "ISLAM",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085002448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.