Healthcare Provider Details

I. General information

NPI: 1235821943
Provider Name (Legal Business Name): VIRTUMED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 W 15TH ST STE 435
PLANO TX
75093-5845
US

IV. Provider business mailing address

455 N CITYFRONT PLAZA DR STE 2515
CHICAGO IL
60611-5323
US

V. Phone/Fax

Practice location:
  • Phone: 408-518-2712
  • Fax: 630-566-8294
Mailing address:
  • Phone: 408-518-2712
  • Fax: 630-566-8294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RIZWAN KHAN
Title or Position: OWNER
Credential:
Phone: 408-518-2712