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NPI Code Detail

MEDICARE: ASRA KHAN PHARM. D.

MEDICARE: ASRA KHAN PHARM. D.
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
1183500000XPharmacist051289888IL

General Provider Information

NPI Number : 1528663317
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASRA KHAN PHARM. D.
Provider Business Mailing Address
First Line : 750 BELVEDERE BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60490-5012
Country : US
Telephone Number : 630-697-2419
Fax Number : 815-267-8136
Provider Business Practice Location Address
First Line : 3200 CATON FARM RD
Second Line :
City : JOLIET
State : IL
Zip : 60431-1202
Country : US
Telephone Number : 815-267-8130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ ASRA KHAN PHARM. D.” Practice Location

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