Individual provider Active NPI

Syed J Khan, MD

  • Psychiatry Physician
  • Berwyn, IL
National Provider Identifier
1407807746
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036120854 Issued in IL
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-3601
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01061501A IN
Psychiatry Physician 2084P0800X 036120854 IL Primary
Child & Adolescent Psychiatry Physician 2084P0804X 01061501A IN

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-3601

Other practice location 1

3500 S LaFountain St
Kokomo, IN 46902-3803
Phone (765) 453-8547

Other identifiers 10

IdentifierTypeStateIssuer
388979OtherINMANAGED HEALTH NETWORK
577438OtherINVALUE OPTIONS
D03211OtherINMEDICARE RR GRP#
P01191767OtherINRR MEDICARE PTAN
000000775649OtherINANTHEM
209931580AMedicaidIN
000000691246OtherINANTHEM
200825610MedicaidIN
2298696OtherINCIGNA BEHAVIORAL HEALTH
7029777OtherINAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhan151846@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20061031000434 IN Practitioner - Psychiatry 8224035480 Reassigns benefits to 4 organizations
I20220114001441 IL Practitioner - Psychiatry 8224035480 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
BHC Streamwood Hospital IncGroup PAC ID 1759291461, 13 clinicians
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

1400 E Irving Park Rd
Streamwood, IL 60107-3201
Phone (630) 837-9000

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-0700

Hospital & facility affiliations

  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Streamwood Hospital Inc. CurrentSince Nov 15, 2021 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Loyola University Medical Center CurrentSince Jan 1, 2024 Accepting new patients
State of Indiana, Auditor of State CurrentSince Apr 23, 2019 Accepting new patients
Loyola University Medical Center CurrentSince Jan 1, 2024 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 13, 2013 Accepting new patients
Loyola Medical Group LLC CurrentSince Apr 1, 2022 Accepting new patients
State of Indiana, Auditor of State CurrentSince Apr 23, 2019 Accepting new patients
Community Health Network, Inc CurrentSince Nov 1, 2017 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 13, 2013 Accepting new patients
State of Indiana, Auditor of State Current Accepting new patients
Loyola University Medical Center Current Accepting new patients
Serenity Medical Center West LLC Psychiatry CurrentSince Jan 1, 2012 Accepting new patients
Community Health Network, Inc. Past Accepting new patients
Serenity Medical Associates Past Accepting new patients
Community Health Network, Inc Past Accepting new patients

Locations

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

5819 Reliable Pkwy
Chicago, IL 60686

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1400 E Irving Park Rd
Streamwood, IL 60107
Phone (630) 483-5578

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

3400 Lincoln Ave
Evansville, IN 47714
Phone (812) 469-6800

10765 Lantern Rd
Ste 110
Fishers, IN 46038
Phone (317) 621-4170

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7250 Clearvista Dr
Ste 227
Indianapolis, IN 46256
Phone (317) 621-7804

5435 E 16th St
Indianapolis, IN 46218
Phone (317) 941-4000

7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041

1340 E County Line Rd
Ste O
Indianapolis, IN 46227
Phone (317) 497-6290

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

1098 S State Road 25
Logansport, IN 46947
Phone (574) 722-4141

Organizations & group practices 17

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.

View all 17

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1407807746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-3601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 S LaFountain St",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469023803",
            "country_code": "US",
            "telephone_number": "765-453-8547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SYED",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01061501A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036120854",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IN",
            "license": "01061501A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "388979",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "577438",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GRP#",
            "identifier": "D03211",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01191767",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000775649",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209931580A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000691246",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200825610",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2298696",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7029777",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhan151846@direct.luhs.org",
            "affiliation": "N",
            "endpointDescription": "skhan151846@direct.luhs.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3249 Oak Park Ave",
            "city": "Berwyn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604023429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.