MEDICARE: GOWHAR A 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	207R00000X	Internal Medicine Physician	036087821	IL
2	207RR0500X	Rheumatology Physician	036087821	IL

General Provider Information

NPI Number	:	1518917673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GOWHAR A KHAN MD

Provider Business Mailing Address
First Line	:	2309 BILTER RD
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60502-8714
Country	:	US
Telephone Number	:	630-802-8644
Fax Number	:	630-801-7511

Provider Business Practice Location Address
First Line	:	1177 N HIGHLAND AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-2281
Country	:	US
Telephone Number	:	630-802-8644
Fax Number	:	630-801-7511

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	04/11/2022

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