Individual
DR. MANSOOR KHAN
Active
Individual
DR. MANSOOR KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-093169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110189123
RAILROAD MEDICARE
IL
01
—
364302965
TAX IDENTIFICATION NUMBER
IL
Enumeration date
11/03/2006
Last updated
04/08/2009
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