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FIDAK KHAN MD
NPI 1992400998
Student in an Organized Health Care Education/Training Program in Maywood, IL

Active since March 31, 2023PECOS Enrolled
2160 S 1ST AVE RM 2709, MAYWOOD, IL 60153(773) 216-2687 Get Directions Write a Review

NPPES record last updated: May 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 17, 2023, Mar 31, 2023 (2 updates tracked since 2023).

About Fidak Khan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FIDAK KHAN MD (NPI 1992400998) is an individual student in an organized health care education/training program in Maywood, Illinois, licensed in Illinois (125.081289) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992400998
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameFIDAK KHANCredential: MD
Location Address2160 S 1ST AVE RM 2709Maywood, IL 60153-3328
Mailing Address2160 S 1st Ave Rm 2709Maywood, IL 60153-3328
Phone(773) 216-2687
Sole ProprietorYes
Enumeration DateMarch 31, 2023
Last NPPES UpdateMay 17, 20232 updates tracked since enumeration
NPPES CertifiedMay 17, 2023
✔ NPI 1992400998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IL · 125.081289
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2160 S 1ST AVE RM 2709, Maywood, IL 60153
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fidak Khan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fidak Khan's NPI number?

The NPI number for Fidak Khan is 1992400998. It was assigned to this individual provider in the NPPES registry on March 31, 2023.

Where is Fidak Khan located?

Fidak Khan practices at 2160 S 1st Ave Rm 2709, Maywood, IL 60153. The listed phone number is (773) 216-2687.

What is Fidak Khan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Fidak Khan enrolled in Medicare?

Yes. Fidak Khan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Fidak Khan was last updated on May 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.