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General NPI Number Information
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NPI Number | 1942434501
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Entity Type | Organization
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Legal Business Name | WAQAR A KHAN MD SC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 616 NELSON LN
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City | WESTMONT
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State | IL
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Zip | 60559-2892
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Country | US
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Telephone | 630-605-0886
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Fax | 866-261-3402
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Provider Business Mailing Address
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Address Line | 616 NELSON LN
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City | WESTMONT
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State | IL
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Zip | 60559-2892
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Country | US
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Telephone | 630-605-0886
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Fax | 866-261-3402
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. WAQAR A KHAN
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Credential | MD
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Telephone | 63060550886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036119080
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License Number State | IL
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