DR. NIZAR KHERALLAH (MD) – Pediatric Pulmonology Physician, NPI 1669467726

DR. NIZAR KHERALLAH (MD) is a healthcare provider. based in Peoria, Illinois. specializing in Pediatric Pulmonology Physician. They hold the professional credentials MD. They hold a License No. 35072648 (OH). The NPI Number for DR. NIZAR KHERALLAH (MD) is 1669467726

Main info

Male
Sole Proprietor
Name
DR. NIZAR KHERALLAH (MD)
NPI
1669467726
Phone
(309) 624-4542
Address
530 NE GLEN OAK AVE
Enumeration Date
15 September 2005
Last Update Date
17 March 2018
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for DR. NIZAR KHERALLAH (MD)

  • OSF Saint Francis Medical Center, 530, Northeast Glen Oak Avenue, East Bluff, Peoria, Peoria County, Illinois, 61637, United States

    PEORIA, IL 616370001

    Phone: (309) 624-4542

    Type: Mailing

  • 2222 Cherry St

    Suite 2900

    Toledo, OH 436082673

    Phone: (419) 251-6430

    Fax: (419) 251-6433

    Type: Location

  • 530 NE GLEN OAK AVE DEPT OF

    PEORIA, IL 616372673

    Phone: (309) 624-9844

    Fax: (309) 624-9844

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $302.

Total Amount is formed as General ($302) + Research ($0) + Ownership ($0) = $302.

Last reported payment date: 2024-11-12 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($116).

Total Amount

$302

General + Research + Ownership

Payments

8

Total payment records

General Amount

$302

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-12

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2019-10-18

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
I20191018000627IPulmonary DiseaseINTBD

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 61637)

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Reviews

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Frequently asked questions

Is DR. NIZAR KHERALLAH (MD) listed with a National Provider Identifier?
Yes — DR. NIZAR KHERALLAH (MD) has NPI 1669467726 on file in the registry.
Is DR. NIZAR KHERALLAH (MD) shown as active in public data?
Registry records indicate DR. NIZAR KHERALLAH (MD) maintains an active NPI.
What kind of doctor is DR. NIZAR KHERALLAH (MD)?
DR. NIZAR KHERALLAH (MD) is associated with Pediatric Pulmonology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DR. NIZAR KHERALLAH (MD) associated with Peoria?
Public fields place DR. NIZAR KHERALLAH (MD) around Peoria, Illinois. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for DR. NIZAR KHERALLAH (MD) is noted as September 15, 2005 where the registry provides it.

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