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General NPI Number Information
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NPI Number | 1477414662
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Entity Type | Organization
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Legal Business Name | KHALIL FOUNDATION
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1946 DAIMLER RD
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City | ROCKFORD
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State | IL
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Zip | 61112-1008
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Country | US
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Telephone | 855-554-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 998 N LOMBARD RD
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City | LOMBARD
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State | IL
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Zip | 60148-1264
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Country | US
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Telephone | 855-554-2545
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGING PARTNER
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Name | MOHSIN KHAN KHAN
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Credential | MD
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Telephone | 815-980-9416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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