Organization
ANARKALI INTERNISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD A KHAN MD (MD)
(773) 354-7041
Entity
Organization
Contact information
Practice address
1035 N MARION ST, OAK PARK, IL 60302-1374
(773) 354-7041
Mailing address
4647 LINCOLN HWY, MATTESON, IL 60443-2319
(708) 915-7190
(708) 915-7194
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036094223
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094223
—
IL
01
—
1629282
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/10/2009
Last updated
10/23/2016
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