Khadija Manzoor

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

500642 Issued in IL

Practice address

501 Davis St
Evanston, IL 60201-4619

Phone

(312) 815-9660

NPI assigned

Sep 2, 2021

Last updated

Sep 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Clarity Clinic Arlington Heights, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arlington Heights, IL
  • NPI 1104341999
  NPD

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1609544782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 LINCOLN AVE",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600533344",
            "telephone_number": "312-813-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DAVIS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014619",
            "telephone_number": "312-815-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZOOR",
        "first_name": "KHADIJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "500642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole S. Mann, MD
• Brittany Manning, MS, CCC-SLP
• Antonietta Mansfield
• Constance B. Manske, MA, LPC
• Heather Noelle Mantey, D.C.
• Aime Maranan
• Maranda Easton PLLC
• Franklin A Marden, MD
• Maren W. Deaver, LCSW PLLC (Maren W. Deaver, LCSW LLC)
• Adam Margol, PSY.D.

• Mental Health Counselor in Evanston, IL
• Providers in Evanston, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.