MEDICARE: HUMAIRA KHATOON 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	207L00000X	Anesthesiology Physician	036095004	IL
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	036095004	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P01156622	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	036095004	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1235144643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUMAIRA KHATOON MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	847-570-5315

Provider Business Practice Location Address
First Line	:	431 SUMMIT STREET
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120
Country	:	US
Telephone Number	:	847-289-8822
Fax Number	:	847-289-0815

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	05/04/2026

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Directions to “ HUMAIRA KHATOON MD” Practice Location

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