NPIMap

Individual provider Active NPI

Nanda Khedkar, M.D

  • Nuclear Imaging & Therapy Physician
  • Des Plaines, IL
National Provider Identifier
1497773295
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X
License
036-049550 Issued in IL
Practice address
249 S River Rd
Des Plaines, IL 60016-3436
Phone
(847) 759-1005
Fax
(847) 759-1009
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 36-049550 IL
Nuclear Imaging & Therapy Physician 207UN0902X 036-049550 IL Primary
Vascular & Interventional Radiology Physician 2085R0204X 036-049550 IL

Addresses

Primary practice location

249 S River Rd
Des Plaines, IL 60016-3436

Mailing address

133 Saint Francis Cir
Oak Brook, IL 60523-2560
Phone (847) 759-1002

Other identifiers 1

IdentifierTypeStateIssuer
036049550MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36-049550ILMDNuclear Cardiology Physician
036-049550ILMDNuclear Imaging & Therapy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Open MRI Past Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients
Midwest Open MRI, Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1497773295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 SAINT FRANCIS CIR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232560",
            "telephone_number": "847-759-1002",
            "fax_number": "847-759-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 S RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600163436",
            "telephone_number": "847-759-1005",
            "fax_number": "847-759-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEDKAR",
        "first_name": "NANDA",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "IL",
            "license": "36-049550",
            "primary": false
        },
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "IL",
            "license": "036-049550",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036-049550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049550",
            "state": "IL"
        }
    ],
    "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 Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.