Individual provider Active NPI

Mohammed Abdul-Vikar Khadeer, DO

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1548759186
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036153525 Issued in IL
Practice address
7435 W Talcott Ave
Chicago, IL 60631
Phone
(773) 792-7921
NPI assigned
May 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125-072293 IL
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 036153525 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Chicago, IL 60631

Mailing address

7435 W Talcott Ave
Chicago, IL 60631-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20200918000016 IL Practitioner - Emergency Medicine 1759631161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lincoln Memorial University Medical Department, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

5645 W Addison St
Chicago, IL 60634-4403
Phone (773) 282-7000

7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036153525ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Healthcare Services Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Community First Healthcare of Illinois, Inc. Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

62311 Collection Ctr Dr
Chicago, IL 60693

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1548759186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60631",
            "telephone_number": "773-792-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADEER",
        "first_name": "MOHAMMED",
        "middle_name": "ABDUL-VIKAR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125-072293",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036153525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.