Individual provider Active NPI

Khalid Sharif-Sidi, M.D.

  • Anesthesiology Physician
  • Iowa City, IA
National Provider Identifier
1417308974
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036153723 Issued in IL
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2210
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R-10698 IA
Anesthesiology Physician 207L00000X 036153723 IL Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (224) 654-0000

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
I20200901000219 IL Practitioner - Anesthesiology 0547553869 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 759-4323

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-10698IAMDAnesthesiology Physician
036153723ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Town Square Anesthesia LLC Anesthesiology CurrentSince Aug 24, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 29, 2020 Accepting new patients
Huntley Anesthesia Associates LLC Anesthesiology CurrentSince Sep 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2024 Accepting new patients
Oak Brook Anesthesiologists, LTD. Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 29, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

1800 McDonough Rd
Ste 100
Hoffman Estates, IL 60192
Phone (630) 928-1103

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

2425 W 22nd St
Ste 101
Oak Brook, IL 60523
Phone (630) 312-5000

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

3703 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

Organizations & group practices 7

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1417308974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "224-654-0000",
            "fax_number": "224-654-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARIF-SIDI",
        "first_name": "KHALID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R-10698",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036153723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.