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General NPI Number Information
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NPI Number | 1275855694
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Entity Type | Organization
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Legal Business Name | ANWAR A. KHAN, M.D., LTD
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 02/26/2010
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Provider Practice Location Address
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Address Line | 4010 N ILLINOIS ST STE 2
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City | SWANSEA
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State | IL
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Zip | 62226-1967
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Country | US
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Telephone | 618-235-6867
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Fax | 618-235-9732
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Provider Business Mailing Address
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Address Line | 4010 N ILLINOIS ST STE 2
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City | SWANSEA
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State | IL
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Zip | 62226-1967
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Country | US
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Telephone | 618-235-6867
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Fax | 618-235-9732
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANWAR AHMED KHAN
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Credential | M.D.
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Telephone | 618-235-6867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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