Individual
HIBAH KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 W WELLINGTON AVE, CHICAGO, IL 60657-5123
(773) 871-1461
Mailing address
811 W WELLINGTON AVE, CHICAGO, IL 60657-5123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034261
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2023
Last updated
06/21/2023
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