Active NPI
Izza Aftab Khan, M.D
- Pediatrics Physician
- Des Plaines, IL
National Provider Identifier
1467685339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 125057263
- Practice address
- 9012 N Washington Dr Apt 1H
Des Plaines
Des Plaines, IL 60016-5054 - Phone
- (708) 770-8143
- NPI assigned
- Aug 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125057263 | IL | Primary |
Addresses
Primary practice location
9012 N Washington Dr Apt 1H
Des Plaines
Des Plaines, IL 60016-5054
Mailing address
9012 N Washington Dr Apt 1H
Des Plaines
Des Plaines, IL 60016-5054
Phone (708) 770-8143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125057263 | IL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251244800000",
"number": "1467685339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9012 N WASHINGTON DR APT 1H",
"address_2": "DES PLAINES",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600165054",
"telephone_number": "708-770-8143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9012 N WASHINGTON DR APT 1H",
"address_2": "DES PLAINES",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600165054",
"telephone_number": "708-770-8143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "IZZA",
"middle_name": "AFTAB",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-26",
"last_updated": "2009-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125057263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Plaines, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.