Mohammed Adnan Khaleeluddin, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036152505 Issued in IL

Practice address

19310 S Halsted St
Glenwood, IL 60425-1562

Phone

(708) 300-3132

Fax

(708) 300-3149

NPI assigned

Mar 15, 2017

Last updated

Jul 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mohammed Adnan Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• PMR Illinois Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1770038671

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1609317387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19310 S HALSTED ST",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251562",
            "telephone_number": "708-300-3132",
            "fax_number": "708-300-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19310 S HALSTED ST",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251562",
            "telephone_number": "708-300-3132",
            "fax_number": "708-300-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADNAN KHALEELUDDIN",
        "first_name": "MOHAMMED",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-15",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036152505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMED",
            "last_name": "ADNAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• A T & J Transportation Corporation
• Acustom Transport Services
• Christina C Adams, LCSW
• Advocate Home Health Care and Wellness Council, Inc. (Advocate Home Health)
• Ahava Home Health, Inc.
• Aliya of Glenwood LLC
• Yvonne Annette Allen
• Aperion Care Glenwood LLC (Aperion Care Glenwood)

• Family Medicine Physician in Glenwood, IL
• Providers in Glenwood, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.