MEDICARE: AISHA KHAN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	016005150	IL

General Provider Information

NPI Number	:	1134371057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AISHA KHAN DPM

Provider Business Mailing Address
First Line	:	6940 N KEATING AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-2408
Country	:	US
Telephone Number	:	713-992-6113
Fax Number	:	224-251-8861

Provider Business Practice Location Address
First Line	:	6353 N FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1705
Country	:	US
Telephone Number	:	773-954-6414
Fax Number	:	224-251-8861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	09/12/2023

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Directions to “ AISHA KHAN DPM” Practice Location

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