Healthcare Provider Details

I. General information

NPI: 1518595933
Provider Name (Legal Business Name): HARIS SALEEM KHAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 N RANDALL RD
ELGIN IL
60123-7900
US

IV. Provider business mailing address

5212 HARMSWOOD TER
SKOKIE IL
60077-1110
US

V. Phone/Fax

Practice location:
  • Phone: 847-468-1994
  • Fax:
Mailing address:
  • Phone: 847-431-5212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016.006036
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: