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General NPI Number Information
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NPI Number | 1871028621
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Entity Type | Organization
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Legal Business Name | KHAN CHIROPRACTIC CLINIC INC.
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Dates
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Enumeration Date | 04/28/2017
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 5842 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60634-2622
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Country | US
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Telephone | 773-283-3636
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Fax | 773-283-0091
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Provider Business Mailing Address
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Address Line | 5842 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60634-2622
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Country | US
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Telephone | 773-283-3636
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Fax | 773-283-0091
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. BILAL KHAN
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Credential | D.C.
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Telephone | 773-283-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038012601
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License Number State | IL
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