Individual provider Active NPI

Khaja A Nasaruddin, M.D.

  • Anesthesiology Physician
  • Woodstock, IL
National Provider Identifier
1679575658
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036089350 Issued in IL
Practice address
3701 Doty Rd
Woodstock, IL 60098-7509
Phone
(815) 334-3170
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036089350 IL Primary

Addresses

Primary practice location

3701 Doty Rd
Woodstock, IL 60098-7509

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

Other practice location 1

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (224) 654-0000

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
I20040806000891 IL Practitioner - AnesthesiologyPractitioner - Pain Management 7012815137 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

10400 Haligus Rd
Lowr Level
Huntley, IL 60142-9553
Phone (224) 654-0800

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036089350ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 1, 2020 Accepting new patients
Oak Brook Anesthesiologists, LTD. Anesthesiology CurrentSince Jun 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2024 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 1, 2020 Accepting new patients
Town Square Anesthesia LLC Anesthesiology CurrentSince Oct 1, 2003 Accepting new patients
Huntley Anesthesia Associates LLC Anesthesiology CurrentSince Jul 15, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2024 Accepting new patients

Locations

1580 W Lake St
Ste 100
Addison, IL 60101
Phone (630) 285-7000

1925 E Rand Rd
Arlington Hts, IL 60004
Phone (224) 735-3522

Dept 5777
Carol Stream, IL 60122

7616 N Paulina St
Chicago, IL 60626
Phone (773) 368-3164

4849 W Fullerton Ave
Chicago, IL 60639
Phone (773) 237-2900

17 W Grand Ave
Chicago, IL 60654
Phone (312) 222-5610

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

999 E Touhy Ave
Ste 350
Des Plaines, IL 60018
Phone (224) 725-5850

1800 McDonough Rd
Ste 100
Hoffman Estates, IL 60192
Phone (630) 928-1103

10400 Haligus Rd
Lowr
Huntley, IL 60142
Phone (224) 654-0800

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

520 E 22nd St
Lombard, IL 60148
Phone (630) 874-2542

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

8780 W Golf Rd
Ste 304
Niles, IL 60714
Phone (847) 297-8900

2425 W 22nd St
Ste 101
Oak Brook, IL 60523
Phone (630) 312-5000

10 Orland Square Dr
Ste 10C
Orland Park, IL 60462
Phone (708) 942-6030

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

3703 Doty Rd
Unit 7
Woodstock, IL 60098
Phone (815) 334-8600

3703 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

3701 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

Organizations & group practices 7

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 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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1679575658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-874-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 DOTY RD",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987509",
            "telephone_number": "815-334-3170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10400 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429553",
            "country_code": "US",
            "telephone_number": "224-654-0000",
            "fax_number": "224-654-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASARUDDIN",
        "first_name": "KHAJA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036089350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.