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Individual
DR. FAZAL KHAN
Active
Individual
DR. FAZAL KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036104590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080195055
MEDICARE RAILROAD
IL
Enumeration date
05/02/2006
Last updated
04/24/2009
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