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

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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