Healthcare Provider Details

I. General information

NPI: 1093806689
Provider Name (Legal Business Name): NAVEED KHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 S HALSTED ST UNIT 602
CHICAGO IL
60608-2327
US

IV. Provider business mailing address

8201 E RIVERSIDE BLVD
ROCKFORD IL
61114-2300
US

V. Phone/Fax

Practice location:
  • Phone: 312-421-7223
  • Fax: 312-421-7223
Mailing address:
  • Phone: 815-971-7000
  • Fax: 815-968-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036115631
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036115631
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: