Khader Walk in Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

KHADER WALK IN CLINIC LLC

Practice address

6441 W 123Rd St
Palos Heights, IL 60463-1783

Phone

(708) 737-9724

NPI assigned

Sep 12, 2024

Organization subpart

No

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

Authorized official

Name

Mohammad Khader, MDNPI 1093437105

Title

Owner

Phone

(708) 737-9724

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Khader

  • Family Nurse Practitioner
  • Bridgeview, IL
  • NPI 1093437105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1881420099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6441 W 123RD ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6441 W 123RD ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631783",
            "telephone_number": "708-737-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHADER WALK IN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "KHADER",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-737-9724",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanjay Pradeep Keni, M.D.
• Sarita Keni, MD
• Vilija R Kerelis, D.C.
• Dominika Kesek
• Kristina Kevin, APRN, CNP
• Amer Khairallah
• Noorun M Khan, M.D.
• Samina S Khan, M.D.
• Faris Khasawneh, MD
• Raunak Sunil Khisty, MD, MPH

• Family Nurse Practitioner in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.