NPIMap

Individual provider Active NPI

Maria S. Khan, M.D.

  • Nephrology Physician
  • Libertyville, IL
National Provider Identifier
1548476773
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036121625 Issued in IL
Practice address
1272 American Way
Libertyville, IL 60048
Phone
(847) 549-7222
Fax
(866) 954-5804
NPI assigned
May 15, 2007
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036121625 IL Primary

Addresses

Primary practice location

1272 American Way
Libertyville, IL 60048

Mailing address

210 S Desplaines St
Chicago, IL 60661-5500
Phone (312) 654-2721

Other identifiers 1

IdentifierTypeStateIssuer
036121625MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkhan234483@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20090605000474 IL Practitioner - Nephrology 2961552393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Nephrology SCGroup PAC ID 9133023963, 52 clinicians

Practice addresses (Care Compare)

1272 American Way
Libertyville, IL 60048-3936
Phone (847) 549-1632

15 Tower CT
Suite 240
Gurnee, IL 60031-3336
Phone (847) 432-7222

565 Lakeview Pkwy
Vernon Hills, IL 60061-1857
Phone (847) 916-0592

825 W 35TH St
Chicago, IL 60609-1511
Phone (312) 654-2744

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036121625ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Nephrology, S.C. Nephrology CurrentSince Nov 1, 2017 Accepting new patients
Nephrology Specialists SC Nephrology Past Accepting new patients
West Suburban Hospital Medical Center Past Accepting new patients

Locations

4026 Paysphere Cir
Chicago, IL 60674

825 W 35th St
Chicago, IL 60609
Phone (773) 890-4330

15 Tower Ct
Ste 240
Gurnee, IL 60031
Phone (847) 249-1606

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

1272 American Way
Libertyville, IL 60048
Phone (847) 549-1632

Interoperability endpoints

  • Direct secure messaging: gehmakhan@yourcarecommunity.org
  • Direct secure messaging: mkhan18499@direct.acumenmd.com
  • Direct secure messaging: mkhan234483@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1548476773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2721",
            "fax_number": "866-954-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-549-7222",
            "fax_number": "866-954-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MARIA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036121625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036121625",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan234483@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1272 American Way",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1272 American Way",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.