Northstar Rehab Pain Clinics PLLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHSTAR REHAB PAIN CLINICS PLLC

Practice address

131 E Park Ave Ste 103
Libertyville, IL 60048-2858

Phone

(847) 393-6246

Fax

(847) 787-1485

NPI assigned

May 29, 2026

Organization subpart

No

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

Authorized official

Name

Anjum KhanNPI 1851413173

Title

Owner

Phone

(312) 813-6593

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Northstar Rehab Pain Clinics PLLC

  • Physical Medicine & Rehabilitation Physician
  • Libertyville, IL
  • NPI 1134863749

  7810372265

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northstar Rehab Pain Clinics PLLC

  • Physical Medicine & Rehabilitation Physician
  • Libertyville, IL
  • NPI 1134863749

  O20260421001634

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anjum Khan, MD

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1851413173
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1366374035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 E PARK AVE STE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E PARK AVE STE 103",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482858",
            "telephone_number": "847-393-6246",
            "fax_number": "847-787-1485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Pembridge Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600454228",
            "country_code": "US",
            "telephone_number": "847-393-6246",
            "fax_number": "847-787-1485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHSTAR REHAB PAIN CLINICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ANJUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-813-6593"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deborah Renee Norton, LCPC
• Julianna Novelo
• Abby Nowakowski, CRNA

• Durable Medical Equipment & Medical Supplies in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.