Individual provider Active NPI

Haytham Khoury

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1821472408
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
125066093 Issued in IL
Practice address
446 E Ontario St
Suite 10-1000
Chicago, IL 60611-4418
Phone
(312) 695-4960
Fax
(312) 695-4961
NPI assigned
Jul 14, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125066093 IL Primary

Addresses

Primary practice location

446 E Ontario St
Suite 10-1000
Chicago, IL 60611-4418

Mailing address

446 E Ontario St
Suite 10-1000
Chicago, IL 60611-4418
Phone (312) 695-4960

Other names 1

  • Dr. Haytham Khoury Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
125066093ILMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1821472408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 E ONTARIO ST",
            "address_2": "SUITE 10-1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114418",
            "telephone_number": "312-695-4960",
            "fax_number": "312-695-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 E ONTARIO ST",
            "address_2": "SUITE 10-1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114418",
            "telephone_number": "312-695-4960",
            "fax_number": "312-695-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "HAYTHAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125066093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYTHAM",
            "last_name": "KHOURY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Jul 14, 2015; 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.