Individual provider Active NPI

Abbas A Khawaja, M.D.

  • Cardiovascular Disease Physician
  • Aurora, IL
National Provider Identifier
1598711202
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036046187 Issued in IL
Practice address
11 N Edgelawn Dr
Aurora, IL 60506-4362
Phone
(630) 264-3250
Fax
(630) 264-1902
NPI assigned
May 25, 2006
Last updated
Mar 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036046187 IL Primary

Addresses

Primary practice location

11 N Edgelawn Dr
Aurora, IL 60506-4362

Mailing address

11 N Edgelawn Dr
Aurora, IL 60506-4362
Phone (630) 264-3250

Other identifiers 2

IdentifierTypeStateIssuer
036046187MedicaidIL
060052720OtherILMEDICARE RAILROAD

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
I20040313000459 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 1951290295

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036046187ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Community Hospital District Current Accepting new patients
Morrison Community Hospital District Current Accepting new patients
Rush-Copley Medical Group, NFP Past Accepting new patients
Fox Valley Internist Inc. Past Accepting new patients
Cardiology Institute, LTD. Cardiovascular Disease Past Accepting new patients

Locations

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1598711202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 N EDGELAWN DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064362",
            "telephone_number": "630-264-3250",
            "fax_number": "630-264-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N EDGELAWN DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605064362",
            "telephone_number": "630-264-3250",
            "fax_number": "630-264-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAWAJA",
        "first_name": "ABBAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036046187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036046187",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060052720",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.