Active NPI
Anjum F Khan, NP
- Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 277-001490
- Practice address
- 4753 N Broadway St Ste 403
Chicago, IL 60640-7910 - Phone
- (773) 989-2780
- NPI assigned
- Feb 6, 2015
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 14955 | WI | |
| Nurse Practitioner | 363L00000X | 277-001490 | IL | Primary |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 14955-33 | WI | |
| Family Nurse Practitioner | 363LF0000X | 277001490 | IL | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 277001490 | IL |
Addresses
Primary practice location
4753 N Broadway St Ste 403
Chicago, IL 60640-7910
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
11270 N Port Washington Rd
Mequon, WI 53092-3410
Phone (262) 241-1022
Other practice location 2
3134 N Clark St
Chicago, IL 60657-4414
Phone (773) 766-1949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100271382 | Medicaid | WI |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | akhan205504@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, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1440 W Taylor St
Chicago, IL 60607-4623
Phone (415) 360-3348
3134 N Clark St
Chicago, IL 60657-4414
Phone (773) 296-5420
4753 N Broadway St
Suite 403
Chicago, IL 60640-7910
Phone (773) 989-2780
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277-001490 | IL | MD | Nurse Practitioner |
| 277001490 | IL | MD | Family Nurse Practitioner |
| 14955-33 | WI | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Behavioral Care of Colorado, P.C. | Current | Accepting new patients | |
| Optum Behavioral Care of Colorado, P.C. | Current | Accepting new patients | |
| Brightside Medical, P.a. | Current | Accepting new patients |
Locations
2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615
4753 N Broadway St
Ste 403
Chicago, IL 60640
Phone (773) 989-2780
1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334
Interoperability endpoints
- akhan205504@direct.myadvocateaurora.org
- anjum.khan.1@28621.direct.athenahealth.com
Organizations & group practices 4
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.
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- Clinical Psychologist
- Chicago, IL
- NPI 1023888450
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Clinical Social Worker
- De Pere, WI
- NPI 1396622494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775433600000",
"number": "1548651979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4753 N BROADWAY ST STE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606407910",
"telephone_number": "773-989-2780"
}
],
"practiceLocations": [
{
"address_1": "11270 N Port Washington Rd",
"address_purpose": "LOCATION",
"city": "Mequon",
"state": "WI",
"postal_code": "530923410",
"country_code": "US",
"telephone_number": "262-241-1022",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3134 N Clark St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606574414",
"country_code": "US",
"telephone_number": "773-766-1949",
"fax_number": "773-766-4908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "ANJUM",
"middle_name": "F",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-06",
"last_updated": "2026-04-06",
"certification_date": "2026-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "14955",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "277-001490",
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WI",
"license": "14955-33",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "277001490",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "277001490",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100271382",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "akhan205504@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3134 N Clark St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606574414",
"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": "11270 N Port Washington Rd",
"city": "Mequon",
"state": "WI",
"country_code": "US",
"postal_code": "530923410",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 6, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.