Samia Khan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027850 Issued in IL

Practice address

2241 Theodore St
Crest Hill, IL 60403-1881

Phone

(815) 741-1700

NPI assigned

Dec 31, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1760628416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14025 HUNT CLUB LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605447382",
            "telephone_number": "415-624-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 THEODORE ST",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604031881",
            "telephone_number": "815-741-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Jones
• Rolla Naim Kattoum, DMD
• Stephanie Kazantsev, M.D.
• Carly Kelleher, PA-C
• Matthew R Kelleher, MD
• Gaith Khatlan, DMD
• Richard Kiang, M.D.
• Amy Kozak, PT
• John Stephan Kravarik, D.C.
• Kruchten Clinic of Chiropractic

• General Practice Dentistry in Crest Hill, IL
• Providers in Crest Hill, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.