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General NPI Number Information
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NPI Number | 1881878288
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Entity Type | Organization
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Legal Business Name | SUMAYYAH KHAN LTD
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 2109 87TH ST SUITE 300
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City | WOODRIDGE
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State | IL
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Zip | 60517-7575
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Country | US
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Telephone | 630-427-2019
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Fax | 630-427-2018
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Provider Business Mailing Address
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Address Line | 2109 87TH ST SUITE 300
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City | WOODRIDGE
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State | IL
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Zip | 60517-7575
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Country | US
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Telephone | 630-427-2019
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Fax | 630-427-2018
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. SUMAYYAH KHAN
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Credential | DDS
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Telephone | 630-472-2109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 019025700
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License Number State | IL
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