MEDICARE: AKG MEDICAL SERVICE CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036118521	IL

General Provider Information

NPI Number	:	1013208537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKG MEDICAL SERVICE CORPORATION

Provider Business Mailing Address
First Line	:	3403 W THORNDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3405
Country	:	US
Telephone Number	:	773-281-8855
Fax Number	:	773-281-5867

Provider Business Practice Location Address
First Line	:	8344 CONCORD DR
Second Line	:
City	:	MORTON GROVE
State	:	IL
Zip	:	60053-2234
Country	:	US
Telephone Number	:	773-281-8855
Fax Number	:	773-281-5867

Authorized Official
Title or Position	:	MD
Name	:	DR. ATIKA TAMKANAT KHAN
Credential	:	MD
Telephone Number	:	773-281-8855

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	11/09/2017

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Directions to “AKG MEDICAL SERVICE CORPORATION ” Practice Location

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