Mohammad H Khan, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036090466 Issued in IL

Practice address

474 North Lake Shore Drive
Apt 4510
Chicago, IL 60611-6488

Phone

(312) 224-8764

NPI assigned

Nov 22, 2006

Last updated

Sep 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmohammad153313@uihealth.direct-ci.com

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.

• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Glenn Medical Center, LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Willows, CA
  • NPI 1336187178
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• American Advanced Gastroenterology Inc

  • Gastroenterology Physician
  • Colusa, CA
  • NPI 1376041962
  Authorized official Same address or phone
• RMH Pathologists, LTD

  • Anatomic Pathology Physician
  • Rockford, IL
  • NPI 1184671992
  NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1609094739

  Gastroenterology

  NPD
• Glenn Medical Center, LLC

  dba Glenn Medical Rural Health Clinic

  • Rural Health Clinic/Center
  • Willows, CA
  • NPI 1255632790
  NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Stockton, CA
  • NPI 1548343510
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1396810370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 NORTH LAKE SHORE DRIVE",
            "address_2": "APT 4510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116488",
            "telephone_number": "312-224-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 NORTH LAKE SHORE DRIVE",
            "address_2": "APT 4510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116488",
            "telephone_number": "312-224-8764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11104 Parkview Circle Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468451733",
            "country_code": "US",
            "telephone_number": "260-266-5230",
            "fax_number": "260-266-5238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 N Rockton Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611033619",
            "country_code": "US",
            "telephone_number": "815-971-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036090466",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01063260A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396810370",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200458220",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090466",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariha Khan, MD
• Mehdi Khan
• Mehwish A Khan, DO
• Michelle P. Khan, PA-C
• Mohammad Adnan Khan, MD
• Mohammad Rafi Khan
• Mohammed Farhan Khan, MD
• Mona Khan, D.O.
• Moona Salman Khan, M.D
• Muhammad Khan, PHARM.D

• Gastroenterology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.