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

Dr. Mohammad Mushtaq Khandwala, BSC, MD

Individual provider Family Medicine Physician · NPI 1356962740

Dr. Mohammad Mushtaq Khandwala, BSC, MD is a Family Practice in Rockford, Illinois. Qualified in 2018, 8 years ago. Practices with The Board of Trustees of the University of Illinois, a 1,142-clinician group and accepts Medicare assignment. Licensed in Illinois and Minnesota.

Years since qualifying
8
Licensed in
IL, MN
In the registry since
2020
Specialties on file
2
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

1221 E State St
Rockford, IL 61104-2231
Phone: (815) 972-1000
Fax: (815) 972-1086
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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 036172116 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 75001 (MN)

Record details

NPI number1356962740
Entity typeIndividual (Type 1)
GenderMale
Credentials BSC , MD
Sole proprietorNo
NPI enumeratedApril 27, 2020
Last updated in NPPESDecember 17, 2024
Certification dateDecember 17, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice The Board Of Trustees Of The University Of Illinois — 1142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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