Individual provider Active NPI

Saba Khan, MD

  • Family Medicine Physician
  • Merrionette Park, IL
National Provider Identifier
1780172064
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA12364100 Issued in NJ
Practice address
11600 S Kedzie Ave
Merrionette Park, IL 60803-6307
Phone
(708) 272-4150
Fax
(708) 229-0696
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-154928 IL
Student in an Organized Health Care Education/Training Program 390200000X 6996-851 WI
Family Medicine Physician 207Q00000X 25MA12364100 NJ Primary

Addresses

Primary practice location

11600 S Kedzie Ave
Merrionette Park, IL 60803-6307

Mailing address

11600 S Kedzie Ave
Merrionette Park, IL 60803-6307
Phone (708) 272-4150

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address skhan298066@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL, NJ3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190618001066 WI Practitioner - Family Practice 7911230388 Reassigns benefits to 1 organization
I20200402000004 IL Practitioner - Family Practice 7911230388 Reassigns benefits to 3 organizations
I20241011000268 NJ Practitioner - Family Practice 7911230388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

519 Broadway
Suite 3100
Bayonne, NJ 07002-3713
Phone (551) 214-3500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-154928ILMDFamily Medicine Physician
6996-851WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jun 15, 2019 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Rockford Health Physicians CurrentSince Mar 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Rwjbh Primary Care Services Family Medicine CurrentSince Sep 15, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 13, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 15, 2019 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jan 13, 2021 Accepting new patients

Locations

500 W Il Route 22
Barrington, IL 60010
Phone (847) 381-3000

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

29373 Network Pl
Chicago, IL 60673

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

11600 S Kedzie Ave
Merrionette Park, IL 60803
Phone (708) 272-4150

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

519 Broadway
Ste 3100
Bayonne, NJ 07002
Phone (551) 214-3500

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

849 Kellogg Ave
Janesville, WI 53546
Phone (608) 755-7960

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: skhan298066@direct.myadvocateaurora.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1780172064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307",
            "telephone_number": "708-272-4150",
            "fax_number": "708-229-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 S KEDZIE AVE",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "608036307",
            "telephone_number": "708-272-4150",
            "fax_number": "708-229-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SABA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-154928",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "6996-851",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA12364100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhan298066@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11600 S Kedzie Ave",
            "city": "Merrionette Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608036307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "11600 S Kedzie Ave",
            "city": "Merrionette Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608036307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merrionette Park, IL

Sources for this page

Verify at the official NPI Registry.