Individual provider Active NPI

Sonia Khan, D.O.

  • Emergency Medicine Physician
  • Rockford, IL
National Provider Identifier
1710341987
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036152195 Issued in IL
Practice address
1401 E State St
Rockford, IL 61104-2315
Phone
(630) 202-5952
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036152195 IL Primary

Addresses

Primary practice location

1401 E State St
Rockford, IL 61104-2315

Mailing address

10S237 Birnam TRL
Willowbrook, IL 60527-6008
Phone (630) 202-5952

Other practice location 1

20201 Crawford Ave
Attn: Postdoctoral Education
Olympia Fields, IL 60461-1010
Phone (708) 747-4000

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
I20200901000767 IL Practitioner - Emergency Medicine 0446548226 Reassigns benefits to 2 organizations
I20220222001841 IN Practitioner - Emergency Medicine 0446548226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Practice addresses (Care Compare)

24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
78.11
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.27 of 100Reported as group
Quality
74.46
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036152195ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 25, 2023 Accepting new patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Belvidere Emergency Physicians, LLC Emergency Medicine CurrentSince Aug 25, 2023 Accepting new patients

Locations

1625 S State St
Belvidere, IL 61008
Phone (815) 544-1846

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

Interoperability endpoints

  • Direct secure messaging: skhan175652@direct.franciscanalliance.org

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 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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1710341987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10S237 BIRNAM TRL",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605276008",
            "telephone_number": "630-202-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "630-202-5952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20201 Crawford Ave",
            "address_2": "Attn: Postdoctoral Education",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "708-747-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SONIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036152195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.