Mohammad Ajmal Khan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036094223 Issued in IL

Practice address

610 S Maple Ave
Suite 3440
Oak Park, IL 60304-1091

Phone

(708) 660-5017

Fax

(708) 660-5349

NPI assigned

Jul 19, 2005

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Butler Physician Services, LLC

  • Internal Medicine Physician
  • Poplar Bluff, MO
  • NPI 1982056545
  Medicare reassignment NPD
• Cole Physician Services LLC

  • Hospitalist Physician
  • Jefferson City, MO
  • NPI 1144578659
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454

  Internal Medicine

  NPD
• Kohli & Khan Internists MD SC

  • Internal Medicine Physician
  • Oak Park, IL
  • NPI 1770573651
  NPD (past)
• MPS Kohli MD SC

  • Internal Medicine Physician
  • Hinsdale, IL
  • NPI 1215176557
  NPD (past)

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1487653838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1120",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604434120",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "SUITE 3440",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-660-5017",
            "fax_number": "708-660-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD",
        "middle_name": "AJMAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094223",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry Allen Keyes, DPM
• Hope Keys
• Fauzia Khan-Alsikafi
• Humaira Khan, MD
• Khurram A Khan, M.D.
• Rahila Khan
• Zainab Khan
• Sunankhem Kheperu
• Suhail A Khokhar, MD, MPH
• Ki Insight LLC

• Internal Medicine Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.