Mohammed Khan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036141637 Issued in IL

Practice address

12935 Gregory St
Blue Island, IL 60406-2428

Phone

(708) 597-2000

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Humboldt Park HealthGroup PAC ID 8921907072, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Humboldt Park Health Hospital, Chicago, IL, CCN 140206

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mokhan@direct-address.org

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.

• Humboldt Park Health

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1740417153

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1588075576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 N LAKE SHORE DR APT 4510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116488",
            "telephone_number": "312-342-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062428",
            "telephone_number": "708-597-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Lake Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575640",
            "country_code": "US",
            "telephone_number": "773-665-3022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036141637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Keenan, LCSW
• Noreen B Keleher, PA-C
• Erin Marie Kelly, LCPC
• Meghan Kelly, LCSW
• Sundoz Kesbeh, DDS
• Sheba Sarwat Khan, D.D.S.
• Jalal Khater
• Abeer J Khouri, PHARM D, BCPS
• Pamela Kilcrease
• Mark Kevin Kirkwood, D.O.

• Internal Medicine Physician in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.