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NPI Code Detail

MEDICARE: SADAF KHAN OD

MEDICARE:   SADAF  KHAN  OD
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
1152W00000XOptometrist046011172IL

General Provider Information

NPI Number : 1245736545
Entity Type Code : Individual
Provider Name (Legal Business Name) : SADAF KHAN OD
Provider Business Mailing Address
First Line : 6906 LYONS ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-1310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6906 LYONS ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-1310
Country : US
Telephone Number : 847-863-7497
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 04/04/2018

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Directions to “ SADAF KHAN OD” Practice Location

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