Doctor Name: | MR. IFTIKHAR KHAN |
NPI Number: | 1679510986 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036112317 |
Business Practice Address: | 519 S Roselle Rd Schaumburg, IL - 601932925 |
Business Phone Number: | 8476194000 |
Business Fax Number: | |
Mailing Address: | 1430 S Michigan Ave, Unit C2 CHICAGO |
State: | IL |
Postal Code: | 606052960 |
Phone Number: | 8476194000 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036112317 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |