Individual provider Active NPI

Myra Khan, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Ann Arbor, MI
National Provider Identifier
1588075162
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
5101025342 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036146603 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 5101025342 MI Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 81596-21 WI

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Other practice location 2

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other practice location 3

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Other practice location 4

1000 Mineral Point Ave
Janesville, WI 53548-2982
Phone (608) 756-6868

Other practice location 5

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211101001357 IL Practitioner - Pathology 5991008955 Reassigns benefits to 5 organizations
I20241112001615 WI Practitioner - Pathology 5991008955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians
Freeport Memorial HospitalGroup PAC ID 8426958232, 168 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000

875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036146603ILMDAnatomic Pathology & Clinical Pathology Physician
5101025342MIMDAnatomic Pathology & Clinical Pathology Physician
81596-21WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Nov 1, 2021 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Mercy Health System Corporation CurrentSince Feb 9, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Feb 9, 2024 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

901 Grant St
Harvard, IL 60033
Phone (815) 943-5431

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: mkhan87192@direct.mhemail.org

Organizations & group practices 9

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 4

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1588075162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Grant St",
            "address_purpose": "LOCATION",
            "city": "Harvard",
            "state": "IL",
            "postal_code": "600331821",
            "country_code": "US",
            "telephone_number": "815-943-5431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482982",
            "country_code": "US",
            "telephone_number": "608-756-6868",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MYRA",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036146603",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "5101025342",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "81596-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.