Active NPI
Nasreen Khan, M.D
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1518974310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 36-56673
- Practice address
- 4633 N Clark St
Chicago, IL 60640-4619 - Phone
- (773) 275-7500
- Fax
- (773) 275-0449
- NPI assigned
- Aug 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36-56673 | IL | Primary |
Addresses
Primary practice location
4633 N Clark St
Chicago, IL 60640-4619
Mailing address
4633 N Clark St
Chicago, IL 60640-4619
Phone (773) 275-7500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36-56673 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & W Medical LLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lagrange Medical Center
- Internal Medicine Physician
- Chicago, IL
- NPI 1538179841
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518974310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4633 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404619",
"telephone_number": "773-275-7500",
"fax_number": "773-275-0449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4633 N CLARK ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606404619",
"telephone_number": "773-275-7500",
"fax_number": "773-275-0449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "NASREEN",
"name_prefix": "Mrs.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "36-56673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.