Maria Khattak, M.D.
Individual provider Active NPI Family Medicine Physician · Springfield, IL
NPI 1740545441 · NPPES record last updated Dec 4, 2015
Key facts
- NPI
- 1740545441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036136594 (IL)
- Practice address
- 1836 S Macarthur Blvd
Springfield, IL 62704-4030 - Phone
- (217) 789-1403
- Fax
- (217) 789-1825
- NPI assigned
- Jul 9, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ottawa Regional Hospital and Healthcare Center
Practice addresses (Care Compare)
1640 1St Ave
Ottawa, IL 61350-9214
Phone (815) 431-9208
Hospital & facility affiliations
- Osf Saint Elizabeth MDL Ctr
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151228000405 | IL | Practitioner - Family Practice | 9335388172 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ottawa Regional Hospital & Healthcare Center | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Family Medicine | Current |
Accepting new patients |
| HSHS Medical Group Inc | Past |
Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Past | Accepting new patients |
Locations
1640 1st Ave
Ottawa, IL 61350
Phone (815) 431-9208
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036136594 | IL | Yes |
Addresses
Primary practice location
1836 S Macarthur Blvd
Springfield, IL 62704-4030
Mailing address
1836 S Macarthur Blvd
Springfield, IL 62704-4030
Phone (217) 789-1403
Other providers in Springfield, IL
- Sana Khan
- Sheri Khan
- Narinder N Khanna
- Vjatscheslav Kharitonenkov
- Binod Khatiwada
- Saquib Khawar
- Naim Khoury
- Savannah Kidd
- Kyle Kieffer
- Peter S Kieffer
All providers in Springfield, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.