Individual provider Active NPI

Anmol Saba Khattak, M.D.

  • Hospitalist Physician
  • Huntley, IL
National Provider Identifier
1790133429
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036.154767 Issued in IL
Practice address
10400 Haligus Rd
Huntley, IL 60142-9553
Phone
(815) 759-4323
Fax
(815) 759-4948
NPI assigned
Jun 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.154767 IL
Hospitalist Physician 208M00000X 036.154767 IL Primary

Addresses

Primary practice location

10400 Haligus Rd
Huntley, IL 60142-9553

Mailing address

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 759-4323

Other practice location 1

4646 N Marine Dr
Chicago, IL 60640-5759
Phone (773) 564-5235

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210217002063 IL Practitioner - HospitalistPractitioner - Internal Medicine 0547553406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 759-4323

Hospital & facility affiliations

  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.154767ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Jan 28, 2021 Accepting new patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jan 28, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

10400 Haligus Rd
Huntley, IL 60142
Phone (224) 654-0000

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 4

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 3

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": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1790133429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429553",
            "telephone_number": "815-759-4323",
            "fax_number": "815-759-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429553",
            "telephone_number": "815-759-4323",
            "fax_number": "815-759-4948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 N Marine Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606405759",
            "country_code": "US",
            "telephone_number": "773-564-5235",
            "fax_number": "773-564-5226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "ANMOL",
        "middle_name": "SABA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.154767",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.154767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

Verify at the official NPI Registry.