NIDA KHAN (MSN, APRN, FNP-C) – Nurse Practitioner, NPI 1457029977

NIDA KHAN (MSN, APRN, FNP-C) is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, APRN, FNP-C. They hold a License No. 041.461582 (IL). The NPI Number for NIDA KHAN (MSN, APRN, FNP-C) is 1457029977

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
NIDA KHAN (MSN, APRN, FNP-C)
NPI
1457029977
Phone
(773) 794-7601
Address
5645 W ADDISON ST
Enumeration Date
31 August 2021
Last Update Date
27 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7084344090
Graduation Year
2020 (6 years ago)
PAC ID
3072911247
Group Practice PAC ID
2062806490
Professional Enrollment ID
I20211101000748
Address ID
IL603011099OA1100XSTXX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for NIDA KHAN (MSN, APRN, FNP-C)

  • 5645 W ADDISON ST

    CHICAGO, IL 606342881

    Phone: (773) 794-7601

    Type: Location

  • 916 LANCASTER AVE

    DOWNERS GROVE, IL 605162908

    Phone: (224) 200-9000

    Type: Mailing

  • 6841 DEMPSTER ST

    MORTON GROVE, IL 600532628

    Phone: (224) 200-9000

    Type: Location

  • 5645 W Addison St

    Chicago, IL 606342881

    Phone: (773) 794-7601

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-11-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20211101000748INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60634)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062806490View full group profile
NameSpecialtyState
Physician AssistantIL
Psychiatry, Addiction Medicine, Geriatric PsychiatryIL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Where can patients find NIDA KHAN (MSN, APRN, FNP-C)'s NPI?
You can confirm NIDA KHAN (MSN, APRN, FNP-C) with NPI 1457029977; it appears in the national provider directory.
Is NIDA KHAN (MSN, APRN, FNP-C)'s NPI currently valid?
The extract we use shows NIDA KHAN (MSN, APRN, FNP-C) as active.
What kind of provider is NIDA KHAN (MSN, APRN, FNP-C)?
The page reflects Nurse Practitioner for NIDA KHAN (MSN, APRN, FNP-C). Clinical services aligned with this taxonomy classification.
Where does public data place NIDA KHAN (MSN, APRN, FNP-C)?
The snapshot lists Chicago, Illinois for NIDA KHAN (MSN, APRN, FNP-C); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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