MEDICARE: NAVEED KHAN MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	036115631	IL
2	208000000X	Pediatrics Physician	036115631	IL

General Provider Information

NPI Number	:	1093806689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAVEED KHAN MD

Provider Business Mailing Address
First Line	:	1601 S HALSTED ST
Second Line	:	UNIT 602
City	:	CHICAGO
State	:	IL
Zip	:	60608-2327
Country	:	US
Telephone Number	:	312-421-7223
Fax Number	:	312-421-7223

Provider Business Practice Location Address
First Line	:	1601 S HALSTED ST
Second Line	:	UNIT 602
City	:	CHICAGO
State	:	IL
Zip	:	60608-2327
Country	:	US
Telephone Number	:	312-421-7223
Fax Number	:	312-421-7223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	03/19/2021

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