MEDICARE: SABAH A KHAN M.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
1	207R00000X	Internal Medicine Physician	036084303	IL

General Provider Information

NPI Number	:	1992778534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABAH A KHAN M.D.

Provider Business Mailing Address
First Line	:	4646 N MARINE DR
Second Line	:	SUITE 6200C
City	:	CHICAGO
State	:	IL
Zip	:	60640-5759
Country	:	US
Telephone Number	:	773-564-5313
Fax Number	:	773-564-5314

Provider Business Practice Location Address
First Line	:	4646 N MARINE DR
Second Line	:	SUITE 6200C
City	:	CHICAGO
State	:	IL
Zip	:	60640-5759
Country	:	US
Telephone Number	:	773-564-5313
Fax Number	:	773-564-5314

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	03/25/2014

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