Healthcare Provider Details

I. General information

NPI: 1497592935
Provider Name (Legal Business Name): USMAN KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 02/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612
US

IV. Provider business mailing address

1444 W AUGUSTA BLVD UNIT 201
CHICAGO IL
60642
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone: 613-983-8721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.169580
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number036.169580
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: