Individual provider Active NPI

Aliza Khatiwada, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1366177107
Registry record updated Jul 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125079237 Issued in IL
Practice address
4646 N Marine Dr FL 7100
Chicago, IL 60640-5759
Phone
(773) 564-5225
NPI assigned
Jul 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125079237 IL Primary

Addresses

Primary practice location

4646 N Marine Dr FL 7100
Chicago, IL 60640-5759

Mailing address

4646 N Marine Dr FL 7100
Chicago, IL 60640-5759
Phone (773) 564-5225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20250711000407 WI Practitioner - Internal Medicine 8325421795 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3801 Spring St
Mount Pleasant, WI 53405-1667
Phone (262) 687-4011

Hospital & facility affiliations

  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 1, 2025 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Jun 1, 2025 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 1, 2025 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Jun 1, 2025 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Jun 1, 2025 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Past Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

2320 N Lake Dr
Ste 3603
Milwaukee, WI 53211
Phone (414) 270-4932

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 6

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 1

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": "1658016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1366177107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR FL 7100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-564-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR FL 7100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-564-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIWADA",
        "first_name": "ALIZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-17",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125079237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.