Individual provider Active NPI

Dua Kanwal Iqbal Kalota

  • Physician Assistant
  • Palos Heights, IL
National Provider Identifier
1609678804
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
85.011629 Issued in IL
Practice address
12800 S Ridgeland Ave
Palos Heights, IL 60463-2390
Phone
(708) 429-3700
NPI assigned
Mar 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 85.011629 IL Primary

Addresses

Primary practice location

12800 S Ridgeland Ave
Palos Heights, IL 60463-2390

Mailing address

54 W 19TH St
Lombard, IL 60148-4971
Phone (630) 827-2977

Other practice location 1

8025 Grand Ave
West Des Moines, IA 50266-5360
Phone (515) 271-1569

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260309002491 IL Practitioner - Physician Assistant 4688157647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asad Zaman MD SCGroup PAC ID 5092744847, 9 clinicians

Practice addresses (Care Compare)

12800 S Ridgeland Ave
Suite E
Palos Heights, IL 60463-2391
Phone (708) 429-3700

403 W Galena Blvd
Suite 109
Aurora, IL 60506-3948
Phone (331) 258-9754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85.011629ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Urgent Wellness Center LLC CurrentSince Jan 27, 2026 Accepting new patients

Locations

403 W Galena Blvd
Ste 109
Aurora, IL 60506
Phone (331) 258-9754

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1609678804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W 19TH ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484971",
            "telephone_number": "630-827-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 S RIDGELAND AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632390",
            "telephone_number": "708-429-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8025 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "West Des Moines",
            "state": "IA",
            "postal_code": "502665360",
            "country_code": "US",
            "telephone_number": "515-271-1569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALOTA",
        "first_name": "DUA KANWAL",
        "middle_name": "IQBAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-26",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85.011629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.