NPIMap

Individual provider Active NPI

Imad Ali Khan, DO

  • Emergency Medicine Physician
  • Skokie, IL
National Provider Identifier
1346538345
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.060316 Issued in IL
Practice address
5028 Lee St
Skokie, IL 60077-2335
Phone
(773) 302-3255
NPI assigned
Jul 12, 2011
Last updated
Jul 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125.060316 IL Primary

Addresses

Primary practice location

5028 Lee St
Skokie, IL 60077-2335

Mailing address

5028 W Lee
Skokie, IL 60077
Phone (773) 302-3255

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
I20150702000838 IL Practitioner - Emergency Medicine 5193037216 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City College of Medicine and Surgery, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Emergency Physicians LTDGroup PAC ID 6507854288, 27 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

3815 Highland Ave
Downers Grove, IL 60515-1500
Phone (630) 275-5900

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 655-2431

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.060316ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
St Mary Medical Center CurrentSince Aug 1, 2015 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Dec 27, 2017 Accepting new patients
Saint Francis Medical Center CurrentSince Jul 21, 2014 Accepting new patients
Ottawa Regional Hospital & Healthcare Center CurrentSince Dec 27, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Dupage Emergency Physicians Convenient Care LLC Emergency Medicine CurrentSince Jun 2, 2025 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 10, 2016 Accepting new patients
Saint Francis Medical Center CurrentSince Jul 21, 2014 Accepting new patients
St Mary Medical Center CurrentSince Aug 1, 2015 Accepting new patients

Locations

6840 Main St
Downers Grove, IL 60516
Phone (630) 275-2600

3333 N Seminary St
Galesburg, IL 61401
Phone (309) 344-3161

15900 W 127th St
Lemont, IL 60439
Phone (630) 243-7100

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

5114 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 655-2431

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 11

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 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": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1346538345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 W LEE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60077",
            "telephone_number": "773-302-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5028 LEE ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772335",
            "telephone_number": "773-302-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "IMAD",
        "middle_name": "ALI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.060316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.