Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Audisho Brimo Khoshaba, MD

Individual provider Family Medicine Physician · NPI 1104933191

Dr. Audisho Brimo Khoshaba, MD is a Family Practice in Chicago, Illinois. Qualified in 1973, 53 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
53
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2653 W Peterson Ave
Chicago, IL 60659-4017
Phone: (773) 728-9399
Fax: (773) 728-4162
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036078916 (IL)

Record details

NPI number1104933191
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 24, 2006
Last updated in NPPESJuly 20, 2015
Mailing address2653 W Peterson Ave, Chicago, IL 60659-4017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1973 (53 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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