Individual provider Active NPI

Carley Khan, FNP-C

  • Family Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1992526487
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.030780 Issued in IL
Practice address
16001 108TH Ave
Orland Park, IL 60467-8788
Phone
(708) 460-0007
NPI assigned
Oct 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.030780 IL Primary

Addresses

Primary practice location

16001 108TH Ave
Orland Park, IL 60467-8788

Mailing address

16001 108TH Ave
Orland Park, IL 60467-8788
Phone (708) 460-0007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250122002572 IL Practitioner - Nurse Practitioner 3375072200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

16001 108TH Ave
Suite A2
Orland Park, IL 60467-8789
Phone (708) 460-0007

Hospital & facility affiliations

  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.030780ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest ENT Alliance PLLC CurrentSince Nov 21, 2024 Accepting new patients
Century Ear Nose and Throat - Head and Neck Surgery Associates LTD CurrentSince Nov 21, 2024 Accepting new patients
Bastian Voice Institute, LLC PastSince Sep 22, 2003 Accepting new patients

Locations

3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100

4700 W 95th St
Ste 104
Oak Lawn, IL 60453
Phone (708) 460-0007

16001 108th Ave
Orland Park, IL 60467
Phone (708) 460-0007

16001 108th Ave
Ste A2
Orland Park, IL 60467
Phone (708) 460-0007

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1992526487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "CARLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.