NPIMap

Organization Active NPI

Khalil Center

  • Clinical Psychologist
  • Glen Ellyn, IL
National Provider Identifier
1932578234
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007457 Issued in IL
Legal business name
KHALIL CENTER
Practice address
999 N Main St
Suite 103
Glen Ellyn, IL 60137-3581
Phone
(630) 474-4414
Fax
(630) 230-3364
NPI assigned
Sep 17, 2015
Last updated
Sep 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Hooman KeshavarziNPI 1932449675
Title
Executive Director
Phone
(224) 622-3116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.010934 IL
Professional Counselor 101YP2500X 180.008541 IL
Professional Counselor 101YP2500X 180009783 IL
Clinical Psychologist 103TC0700X 071007457 IL Primary
Psychiatry Physician 2084P0800X 036093319 IL

Addresses

Primary practice location

999 N Main St
Suite 103
Glen Ellyn, IL 60137-3581

Mailing address

999 N Main St
Suite 103
Glen Ellyn, IL 60137-3581
Phone (630) 474-4414

National Provider Directory

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1932578234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 N MAIN ST",
            "address_2": "SUITE 103",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373581",
            "telephone_number": "630-474-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N MAIN ST",
            "address_2": "SUITE 103",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601373581",
            "telephone_number": "630-474-4414",
            "fax_number": "630-230-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALIL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "KESHAVARZI",
        "authorized_official_first_name": "HOOMAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "224-622-3116"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.010934",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008541",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180009783",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007457",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036093319",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.