Individual provider Active NPI

Wajid A Khan, M.D.

  • Psychiatry Physician
  • Joliet, IL
National Provider Identifier
1629162359
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036115038 Issued in IL
Practice address
200 N Hammes Ave
Suite 3
Joliet, IL 60435-6677
Phone
(815) 744-8253
NPI assigned
Oct 3, 2006
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036115038 IL Primary

Addresses

Primary practice location

200 N Hammes Ave
Suite 3
Joliet, IL 60435-6677

Mailing address

185 Penny Ave
East Dundee, IL 60118-1454
Phone (847) 836-7015

Other identifiers 2

IdentifierTypeStateIssuer
0991516762OtherILBCBS
036115038MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060322000273 IL Practitioner - Internal MedicinePractitioner - Psychiatry 7911915624 Reassigns benefits to 2 organizations
I20170322000663 IN Practitioner - Psychiatry 7911915624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mid-America Mental Health LLCGroup PAC ID 9739476201, 11 clinicians

Practice addresses (Care Compare)

700 Ravinia
Orland Park, IL 60462-3700
Phone (815) 744-8253

9335 Calumet Ave
Suite D
Munster, IN 46321-4176
Phone (219) 836-9200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Behavior Health Services LTD Psychiatry CurrentSince Dec 1, 2010 Accepting new patients
Silver Oaks Behavioral, LLC CurrentSince Jan 1, 2021 Accepting new patients
Mid-America Mental Health LLC Psychiatry CurrentSince Mar 13, 2017 Accepting new patients

Locations

10181 W Lincoln Hwy
Frankfort, IL 60423
Phone (630) 444-7003

200 N Hammes Ave
Joliet, IL 60435
Phone (815) 741-0791

200 N Hammes Ave
Ste 3
Joliet, IL 60435
Phone (815) 744-8253

1004 Pawlak Pkwy
New Lenox, IL 60451
Phone (815) 215-3300

700 Ravinia Pl
Orland Park, IL 60462
Phone (708) 226-0010

9335 Calumet Ave
Ste D
Munster, IN 46321
Phone (219) 671-1298

402 Wall St
Ste 23
Valparaiso, IN 46383
Phone (219) 615-3136

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1629162359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PENNY AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181454",
            "telephone_number": "847-836-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N HAMMES AVE",
            "address_2": "SUITE 3",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356677",
            "telephone_number": "815-744-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "WAJID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036115038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0991516762",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115038",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.