Active NPI
Illiana Psychiatric Associates
- Prescribing (Medical) Psychologist
- East Chicago, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- 1038685
- Legal business name
- ILLIANA PSYCHIATRIC ASSOCIATES
- Practice address
- 2010 E Columbus Dr
East Chicago, IN 46312-2830 - Phone
- (219) 397-6369
- NPI assigned
- Mar 20, 2013
- Last updated
- Jun 28, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Farzana A Khan, MD
- Title
- Ceo
- Phone
- (219) 397-6369
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | 1038685 | IN | Primary |
Addresses
Primary practice location
2010 E Columbus Dr
East Chicago, IN 46312-2830
Mailing address
4320 Fir St
Suite 307
East Chicago, IN 46312-3052
Phone (219) 455-8155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100325130 | Medicaid | IN |
National Provider Directory
National Provider Directory- Tax ID family
- Illiana Psychiatric Associates
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Psychologist
- East Chicago, IN
- NPI 1811291248
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- East Chicago, IN
- NPI 1114965084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1561680000000",
"number": "1932441631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4320 FIR ST",
"address_2": "SUITE 307",
"city": "EAST CHICAGO",
"state": "IN",
"postal_code": "463123052",
"telephone_number": "219-455-8155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 E COLUMBUS DR",
"city": "EAST CHICAGO",
"state": "IN",
"postal_code": "463122830",
"telephone_number": "219-397-6369"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ILLIANA PSYCHIATRIC ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-20",
"last_updated": "2019-06-28",
"status": "A",
"authorized_official_last_name": "KHAN",
"authorized_official_first_name": "FARZANA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "219-397-6369",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "IN",
"license": "1038685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100325130",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Chicago, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.