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NPI Code Detail

MEDICARE: DR. MOHAMMAD ADNAN KHAN MD

MEDICARE: DR. MOHAMMAD ADNAN 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
1207Q00000XFamily Medicine Physician036167756IL

General Provider Information

NPI Number : 1679033229
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMAD ADNAN KHAN MD
Provider Business Mailing Address
First Line : 1005 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62301-2834
Country : US
Telephone Number : 217-223-8400
Fax Number :
Provider Business Practice Location Address
First Line : 1276 N CLYBOURN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60610-2003
Country : US
Telephone Number : 312-337-1073
Fax Number : 312-337-7616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 06/01/2026

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