Individual provider Active NPI

Nafisa D Burhani, MD

  • Hematology & Oncology Physician
  • Joliet, IL
National Provider Identifier
1851386460
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036089567 Issued in IL
Practice address
2614 W Jefferson St
Joliet, IL 60435
Phone
(815) 725-1355
Fax
(815) 725-9857
NPI assigned
Sep 20, 2005
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036089567 IL Primary

Addresses

Primary practice location

2614 W Jefferson St
Joliet, IL 60435

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 4

IdentifierTypeStateIssuer
830004996OtherILMEDICARE RR
L82399OtherILMEDICARE INDIV ID# FOR GROUP 336140
036089567MedicaidIL
L98070OtherILMEDICARE INDIV ID# FOR GROUP 205474

Other names 1

  • Mrs. Nafisa D Khokha Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nburhani221113@dulyhealthandcare.direct-ci.com
Direct Messaging Address nburhani221113@direct.edward.org Direct

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
I20041001000751 IL Practitioner - Hematology/Oncology 6800865205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036089567ILMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jan 15, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 15, 2021 Accepting new patients
Medical Specialists of the Palm Beaches Inc Past Accepting new patients
Morris Hospital PastSince Apr 30, 2003 Accepting new patients
Horn & Bache, P.a. Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

2100 Glenwood Ave
Joliet, IL 60435
Phone (815) 999-3201

2614 W Jefferson St
Joliet, IL 60435
Phone (815) 725-1355

301 Madison St
Ste 207
Joliet, IL 60435

17495 La Grange Rd
Tinley Park, IL 60487
Phone (708) 226-7000

Interoperability endpoints

  • Direct secure messaging: nafisab@jolietoncology.direct.varian.com
  • Direct secure messaging: nburhani221113@dulyhealthandcare.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1851386460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W JEFFERSON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-1355",
            "fax_number": "815-725-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURHANI",
        "first_name": "NAFISA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036089567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "830004996",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV ID# FOR GROUP 336140",
            "identifier": "L82399",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089567",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIV ID# FOR GROUP 205474",
            "identifier": "L98070",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nburhani221113@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "2614 W Jefferson St",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nburhani221113@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2614 W Jefferson St",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NAFISA",
            "last_name": "KHOKHA",
            "middle_name": "D",
            "prefix": "MRS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.