Nelli Khallak, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004630A Issued in IN

Practice address

2241 45TH St
Highland, IN 46322-2601

Phone

(219) 922-8051

Fax

(219) 922-8608

NPI assigned

Nov 1, 2013

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 IN, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anthony Hospital Hospital, Chicago, IL, CCN 140095

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Saint Anthony Health Affiliates

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1881086064
  Medicare reassignment Care Compare group NPD
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  Family, IN

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Anthony Hospital

  • General Acute Care Hospital
  • Cicero, IL
  • NPI 1184490062
  Care Compare affiliation
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1194723999
  Care Compare affiliation
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1538655949
  Care Compare affiliation
• Saint Anthony Hospital

  • Children's Hospital
  • Chicago, IL
  • NPI 1619456423
  Care Compare affiliation
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1710877386
  Care Compare affiliation
• Saint Anthony Hospital

  • Community/Retail Pharmacy
  • Chicago, IL
  • NPI 1790490563

  Hospital

  Care Compare affiliation
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1881363224
  Care Compare affiliation
• Saint Anthony Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912397480
  Care Compare affiliation

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1871922740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222601",
            "telephone_number": "219-922-8051",
            "fax_number": "219-922-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222601",
            "telephone_number": "219-922-8051",
            "fax_number": "219-922-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALLAK",
        "first_name": "NELLI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004630A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Marie Kendra, DDS
• Taylor Renee Kendra, DDS
• Kennedy Avenue Chiropractic
• Kennedy Avenue Wellness
• Pyarali M Keshvani, MD
• Amanda Kidd, LSW
• Suzanne Poist Killmer, COTA/L
• Ahna Elizabeth Klassen, RBT
• Jonathan Edward Kledzik
• Stuart M Klein, M.D.

• Family Nurse Practitioner in Highland, IN
• Providers in Highland, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.