Individual provider Active NPI

Muhammad Waqar Khattak, M.D.

  • Nephrology Physician
  • Peoria, IL
National Provider Identifier
1669648309
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036-139349 Issued in IL
Practice address
420 NE Glen Oak Ave Ste 401
Peoria, IL 61603
Phone
(309) 676-8123
Fax
(309) 676-8455
NPI assigned
May 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036-139349 IL Primary

Addresses

Primary practice location

420 NE Glen Oak Ave Ste 401
Peoria, IL 61603

Mailing address

420 NE Glen Oak Ave Ste 401
Peoria, IL 61603-3112
Phone (309) 676-8123

Other practice location 1

1051 W South St
Kewanee, IL 61443-8354
Phone (309) 676-8123

Other practice location 2

1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-6247

Other practice location 3

834 N Seminary St Ste 501
Galesburg, IL 61401
Phone (309) 676-8123

Other practice location 4

525 Grant St 2nd floor
Macomb, IL 61455
Phone (309) 676-8123

Other identifiers 1

IdentifierTypeStateIssuer
036139349MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000133 IL Practitioner - NephrologyPractitioner - Internal Medicine 9739254418 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians
Renalcare Associates, S.C.Group PAC ID 7012818347, 48 clinicians

Practice addresses (Care Compare)

420 NE Glen Oak Ave
Suite 401
Peoria, IL 61603-3112
Phone (217) 238-6247

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-139349ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Renalcare Associates, S.C. Nephrology CurrentSince Jan 1, 2016 Accepting new patients
Mendota Community Hospital CurrentSince Mar 8, 2024 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Jun 1, 2022 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 9, 2021 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Mendota Community Hospital CurrentSince Mar 8, 2024 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Lexica Inpatient Services Past Accepting new patients
Renal Intervention Center, PLLC Nephrology Past Accepting new patients

Locations

180 S Main St
Ste 2I
Canton, IL 61520

834 N Seminary St
Ste 501
Galesburg, IL 61401
Phone (309) 343-3303

1051 W South St
Kewanee, IL 61443
Phone (309) 734-3141

505 E Grant St
Ste 201
Macomb, IL 61455
Phone (309) 833-3068

525 E Grant St
Fl 2
Macomb, IL 61455

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

1050 E Norris Dr
Ste 2C
Ottawa, IL 61350
Phone (815) 431-0785

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

420 NE Glen Oak Ave
Ste 401
Peoria, IL 61603
Phone (309) 624-9259

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • Direct secure messaging: mkhattak7732@direct.acumenmd.com

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1669648309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE STE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033112",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVE STE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 W South St",
            "address_purpose": "LOCATION",
            "city": "Kewanee",
            "state": "IL",
            "postal_code": "614438354",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384644",
            "country_code": "US",
            "telephone_number": "217-238-6247",
            "fax_number": "217-258-4175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "834 N Seminary St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "61401",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Grant St 2nd floor",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "IL",
            "postal_code": "61455",
            "country_code": "US",
            "telephone_number": "309-676-8123",
            "fax_number": "309-676-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "MUHAMMAD",
        "middle_name": "WAQAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036-139349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036139349",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.