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General NPI Number Information
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NPI Number | 1720259591
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Entity Type | Individual
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Provider Name | AISHA ALI KHAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 4155 CRIMSON DR
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-1237
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Country | US
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Telephone | 312-498-7311
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Fax |
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Provider Business Mailing Address
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Address Line | 4155 CRIMSON DRIVE
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192
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Country | US
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Telephone | 312-498-7311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149012553
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License Number State | IL
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