Doctor Name: | IQBAL H KHAN |
NPI Number: | 1053341305 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 016004550 |
Business Practice Address: | 4310 W Crystal Lake Rd Suite F Mchenry, IL - 600504214 |
Business Phone Number: | 8153633223 |
Business Fax Number: | 8153633240 |
Mailing Address: | 4310 W Crystal Lake Rd, Suite F MCHENRY |
State: | IL |
Postal Code: | 600504214 |
Phone Number: | 8153633223 |
Fax Number: | 8153633240 |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 05/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 016004550 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |