Individual provider Active NPI

Mohammed Ali Alkhalifah, MBBS

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1730444183
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036140934 Issued in IL
Practice address
5841 S Maryland Ave
M/C 2030
Chicago, IL 60637-1447
Phone
(773) 702-6222
NPI assigned
Jul 11, 2012
Last updated
Jun 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301100273 MI
Neurology Physician 2084N0400X 036140934 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
M/C 2030
Chicago, IL 60637-1447

Mailing address

180 Harvester Dr
Suite 110,
Burr Ridge, IL 60527-7594
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100273MIMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1730444183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "SUITE 110,",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277594",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "M/C 2030",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHALIFAH",
        "first_name": "MOHAMMED",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301100273",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036140934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.