Individual provider Active NPI

Fahad Habib Khan, PSYD

  • Clinical Psychologist
  • Lombard, IL
National Provider Identifier
1649514266
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009813 Issued in IL
Practice address
998 N Lombard Rd
Lombard, IL 60148
Phone
(630) 474-4414
Fax
(630) 230-3364
NPI assigned
Nov 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178008538 IL
Professional Counselor 101YP2500X 180009783 IL
Clinical Psychologist 103TC0700X 071009813 IL Primary

Addresses

Primary practice location

998 N Lombard Rd
Lombard, IL 60148

Mailing address

998 N Lombard Rd
Lombard, IL 60148-1264
Phone (630) 474-4414

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200616002619 IL Practitioner - Clinical Psychologist 5193147379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178008538ILMDProfessional Counselor
180009783ILMDProfessional Counselor
071009813ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Khalil Foundation CurrentSince Jul 11, 2014 Accepting new patients
Restore Change LLC Clinical Current Accepting new patients

Locations

9836 White Oak Ave
Ste 101
Northridge, CA 91325
Phone (747) 206-1509

998 N Lombard Rd
Lombard, IL 60148
Phone (630) 474-4414

998 N Lombard Rd
Ste 100
Lombard, IL 60148

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": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1649514266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 N LOMBARD RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601481264",
            "telephone_number": "630-474-4414",
            "fax_number": "630-230-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 N LOMBARD RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "60148",
            "telephone_number": "630-474-4414",
            "fax_number": "630-230-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FAHAD",
        "middle_name": "HABIB",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178008538",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009783",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.