NPIMap

Individual provider Active NPI

Khairuddin Memon, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1699037689
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125060936 Issued in IL
Practice address
420 E Superior St
12TH Floor
Chicago, IL 60611-4494
Phone
(312) 503-7975
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125060936 IL Primary

Addresses

Primary practice location

420 E Superior St
12TH Floor
Chicago, IL 60611-4494

Mailing address

1458 Wilmette Ave
Wilmette, IL 60091-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606003069 OK Practitioner - Diagnostic Radiology 8921363227 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians
NRHS Radiology AssociatesGroup PAC ID 2668555731, 61 clinicians

Practice addresses (Care Compare)

Oklahoma City, OK 73107
Phone (907) 749-7474

14204 Calais Cir
Oklahoma City, OK 73142-1854
Phone (501) 609-2222

19793 E Clear Brook Rd
Owasso, OK 74055-7787
Phone (501) 552-3000

3300 Healthplex Pkwy
Norman, OK 73072-9749
Phone (405) 515-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125060936ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NRHS Radiology Associates Diagnostic Radiology CurrentSince Oct 17, 2022 Accepting new patients
Mercy Hospital Ardmore, Inc CurrentSince Nov 2, 2022 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2018 Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Aug 8, 2022 Accepting new patients
Radiology Associates PA Diagnostic Radiology CurrentSince Jul 25, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
St. Vincent Medical Group Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Jul 1, 2018 Accepting new patients
Singleton Associates PA Diagnostic Radiology CurrentSince Jul 6, 2022 Accepting new patients
CHI St. Vincent Medical Group Hot Springs CurrentSince Jul 1, 2025 Accepting new patients
Mercy Hospital Ardmore, Inc. CurrentSince Nov 2, 2022 Accepting new patients
Ou Health Partners, Inc CurrentSince Jul 1, 2021 Accepting new patients
Specialists in Medical Imaging SC Diagnostic Radiology PastSince Jul 6, 2022 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

500 S University Ave
Ste 101
Little Rock, AR 72205
Phone (501) 686-2688

1011 14th Ave NW
Ardmore, OK 73401
Phone (580) 220-6658

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

3600 NW 138th St
Ste 102
Oklahoma City, OK 73134
Phone (800) 266-9910

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

6720 Bertner Ave
#2270
Houston, TX 77030
Phone (832) 355-4092

Interoperability endpoints

  • Direct secure messaging: kmemon29781@ouhealth.direct-ci.net

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1699037689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 WILMETTE AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E SUPERIOR ST",
            "address_2": "12TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114494",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "KHAIRUDDIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125060936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.