Individual
WAQQAS H KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5810
Mailing address
211 S 3RD ST, BELLEVILLE, IL 62220-1915
(618) 234-2120
(618) 641-5810
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036086446
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036086446
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086446
—
IL
Enumeration date
07/31/2006
Last updated
03/10/2011
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