Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1780700419 Deactivated / Inactive NPI Male Practitioner

Dr. Nisaruddin Khan , MD

Ophthalmology • Naperville, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Nisaruddin Khan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 22, 2007
NPI Deactivation Date November 25, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Nisaruddin Khan, MD was a registered Ophthalmology practicing in Naperville, IL. Throughout an active medical career spanning 13 years, Dr. Khan provided care at the practice location at 507 FAIRWAY DR until profile deactivation on 2020-11-25.

Practice Location & Contact Primary Location

Practice Address

507 Fairway Dr
127

Naperville, IL 605634051

Telephone 6308017505
Associated Practice Facility / Clinic
🏢 Medshop Pharmacy Llc Facility NPI 1366537094

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Naperville, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.7 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
13 Specialists

Practicing in Naperville, IL (954 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License IL 036-064447

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1073594750

Doctor of Pharmacy (Pharm.D.), Registered Pharmacist, Master of Business Administration

NPI 1891055943

Doctor of Audiology

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 25, 2020

Record deactivated on November 25, 2020

NPI Profile Active March 25, 2009

NPI status registered as active in NPPES database

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Updated Practice Location March 25, 2009

Registered at 507 FAIRWAY DR, 127, NAPERVILLE, IL 605634051 (Tel: 6308017505)

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Updated Business Mailing Address March 25, 2009

Registered at 11621 S DECATHALON LN, PLAINFIELD, IL 605856144 (Tel: 8152302436)

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Provider Name / Credentials Updated March 25, 2009

Recorded as NISARUDDIN KHAN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 25, 2009

Ophthalmology (License #036-064447 in IL)

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Initial NPI Registration & Enumeration March 22, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780700419
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2007
Last Update: March 25, 2009
Deactivation Date: November 25, 2020

Mailing Address

11621 S Decathalon Ln

Plainfield, IL 605856144

Phone: 8152302436

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.