NPIMap

Individual provider Active NPI

Taariq Ahsan Khan, MD

  • Family Medicine Physician
  • Peoria, IL
National Provider Identifier
1437445202
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036133745 Issued in IL
Practice address
2338 W Van Winkle Way
Suite 3300
Peoria, IL 61615-7483
Phone
(309) 693-2020
NPI assigned
Jun 21, 2011
Last updated
Jul 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036133745 IL Primary

Addresses

Primary practice location

2338 W Van Winkle Way
Suite 3300
Peoria, IL 61615-7483

Mailing address

2338 W Van Winkle Way
Suite 3300
Peoria, IL 61615-7483
Phone (309) 693-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140114000000 IL Practitioner - Family Practice 6709014012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Anthony Medical CenterGroup PAC ID 5496654006, 45 clinicians

Practice addresses (Care Compare)

9951 Rock Cut Xing
Suite 200300
Loves Park, IL 61111-1999
Phone (815) 639-8500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2014 Accepting new patients
Methodist Medical Center of Illinois Family Medicine CurrentSince Aug 1, 2014 Accepting new patients
Saint Anthony Medical Center Family Medicine CurrentSince May 15, 2023 Accepting new patients
Saint Anthony Medical Center CurrentSince May 15, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2018 Accepting new patients
Saint Anthony Medical Center Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Saint Anthony Medical Center Past Accepting new patients

Locations

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

9951 Rock Cut Xing
Loves Park, IL 61111
Phone (815) 639-8450

9951 Rock Cut Xing
Ste 102
Loves Park, IL 61111
Phone (815) 639-8500

9951 Rock Cut Xing
Ste 200
Loves Park, IL 61111

9951 Rock Cut Xing
Ste 300
Loves Park, IL 61111

2338 W Van Winkle Way
Ste 3300
Peoria, IL 61615
Phone (309) 693-2020

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1437445202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY",
            "address_2": "SUITE 3300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157483",
            "telephone_number": "309-693-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W VAN WINKLE WAY",
            "address_2": "SUITE 3300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157483",
            "telephone_number": "309-693-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TAARIQ",
        "middle_name": "AHSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.