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General NPI Number Information
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NPI Number | 1164636585
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Entity Type | Organization
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Legal Business Name | N M KHAN M D S C
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 06/09/2012
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Provider Practice Location Address
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Address Line | 7600 W COLLEGE DR 2ND FLOOR
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1001
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Country | US
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Telephone | 708-671-1800
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Fax | 708-671-1803
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Provider Business Mailing Address
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Address Line | PO BOX 393
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City | WORTH
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State | IL
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Zip | 60482-0393
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Country | US
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Telephone | 630-551-1097
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Fax | 630-551-1097
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Authorized Official
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Title or Position | OWNER
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Name | NOORUN KHAN
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Credential | MD
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Telephone | 630-244-2841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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