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Deactivated NPI 1194955138 Deactivated / Inactive NPI Male Practitioner

Manucher Khodadad , MDMSE (SURG)

Surgery • Winnetka, 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, Manucher Khodadad has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 24, 2009
NPI Deactivation Date August 07, 2025
Total Practice Duration ~16 Years of Practice (2009 – 2025)

Professional Overview & Biography Verified Profile Summary

Manucher Khodadad, MDMSE (SURG) was a registered Surgery practicing in Winnetka, IL. Throughout an active medical career spanning 16 years, Manucher Khodadad provided care at the practice location at 627 SHERIDAN RD. until profile deactivation on 2025-08-07.

Practice Location & Contact Primary Location

Practice Address

627 Sheridan Rd.

Winnetka, IL 60093

Telephone 8474466827
Fax 8474466829

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Winnetka, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 27.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Winnetka, IL (1624 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

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IL 036-040283

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

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 August 07, 2025

Record deactivated on August 07, 2025

NPI Profile Active July 24, 2009

NPI status registered as active in NPPES database

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Updated Practice Location July 24, 2009

Registered at 627 SHERIDAN RD., WINNETKA, IL 60093 (Tel: 8474466827)

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Updated Business Mailing Address July 24, 2009

Registered at 627 SHERIDAN RD., WINNETKA, IL 60093 (Tel: 8474466827)

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Provider Name / Credentials Updated July 24, 2009

Recorded as MANUCHER KHODADAD, M.D. M.SE (SURG)

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 24, 2009

Surgery (License #036-040283 in IL)

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Initial NPI Registration & Enumeration July 24, 2009

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: 1194955138
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2009
Last Update: July 24, 2009
Deactivation Date: August 07, 2025

Mailing Address

627 Sheridan Rd.

Winnetka, IL 60093

Phone: 8474466827

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.