Individual provider Active NPI

Khojasteh Bahmanbeigi, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1356492227
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036111438 Issued in IL
Practice address
7464 N Clark St
Chicago, IL 60626-1620
Phone
(847) 316-2500
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036111438 IL Primary

Addresses

Primary practice location

7464 N Clark St
Chicago, IL 60626-1620

Mailing address

849 W Lakeside PL Apt 2E
Chicago, IL 60640-6746
Phone (773) 275-8893

Other identifiers 2

IdentifierTypeStateIssuer
202649964OtherILFEDERAL TAX ID
036111438MedicaidIL

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
I20050817000093 IL Practitioner - Family Practice 9830129485 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Illinois PC CurrentSince Aug 1, 2013 Accepting new patients
American Current Care of Illinois PC CurrentSince Aug 1, 2013 Accepting new patients

Locations

7421 Cass Ave
Darien, IL 60561
Phone (630) 286-5300

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

555 Valley View Dr
Moline, IL 61265
Phone (309) 764-9675

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243987200000",
    "number": "1356492227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 W LAKESIDE PL APT 2E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606406746",
            "telephone_number": "773-275-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7464 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606261620",
            "telephone_number": "847-316-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHMANBEIGI",
        "first_name": "KHOJASTEH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "202649964",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111438",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.