Healthcare Provider Details

I. General information

NPI: 1588592562
Provider Name (Legal Business Name): SAHAR H KHALAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14933 FOUNDERS XING
HOMER GLEN IL
60491-6712
US

IV. Provider business mailing address

12638 WATERFORD DR
LEMONT IL
60439-2753
US

V. Phone/Fax

Practice location:
  • Phone: 708-737-7968
  • Fax: 708-966-4244
Mailing address:
  • Phone: 708-262-2775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: