Individual provider Active NPI

Khalid F Ahmed, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1922172006
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036051565 Issued in IL
Practice address
6449 S. Pulaski
Chicago, IL 60629
Phone
(773) 581-7300
Fax
(773) 581-7260
NPI assigned
Nov 20, 2006
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Family Medicine Physician 207Q00000X 036051565 IL Primary

Addresses

Primary practice location

6449 S. Pulaski
Chicago, IL 60629

Mailing address

6449 S. Pulaski
Chicago, IL 60629
Phone (773) 581-7300

Other identifiers 2

IdentifierTypeStateIssuer
036051565MedicaidIL
21609255OtherILBCBS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036051565ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services at Home S.C CurrentSince May 17, 2012 Accepting new patients

Locations

900 Jorie Blvd
Ste 58C
Oak Brook, IL 60523
Phone (630) 553-8500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1922172006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6449 S. PULASKI",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-581-7300",
            "fax_number": "773-581-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 S. PULASKI",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-581-7300",
            "fax_number": "773-581-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "KHALID",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036051565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051565",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21609255",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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.