Individual
ASRA F KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 217-3252
(815) 639-8451
Mailing address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 217-3252
(815) 639-8451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-108050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036108050
MEDICAID
IL
01
—
553180
MEDICARE GROUP #
IL
01
—
834340
MEDICARE GROUP #
IL
01
—
F400282877
MEDICARE INDIVIDUAL
IL
01
—
IL6310
MEDICARE GROUP
IL
01
—
P00731185
RAILROAD MEDICARE
IL
Enumeration date
07/28/2005
Last updated
05/12/2017
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