Active NPI
Amir Islam Khan, PA
- Medical Physician Assistant
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 085002448
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Gericare Associates PLLC | Current | Accepting new patients | |
| Northwest Medical Center S.C. | Past | Accepting new patients | |
| Advanced Cancer Clinic LTD | Past | 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.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1003631615
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1366167264
-
- Hematology & Oncology Physician
- Chicago, IL
- NPI 1790779023
-
- Family Medicine Physician
- Park Ridge, IL
- NPI 1831301688
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.