Organization
SELF EMPOWERMENT CENTER, P.C.
Active
Organization
SELF EMPOWERMENT CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASIF A KHAN PSY.D (PRESIDENT)
(630) 774-8316
Entity
Organization
Contact information
Practice address
1751 S NAPERVILLE RD, SUITE 207, WHEATON, IL 60189-5896
(630) 774-8316
(630) 690-3353
Mailing address
1751 S NAPERVILLE RD, SUITE 207, WHEATON, IL 60189-5896
(630) 774-8316
(630) 690-3353
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
071-005466
IL
261QM0850X
Adult Mental Health Clinic/Center
Primary
071-005733
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
071-005466
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623115
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/04/2007
Last updated
09/02/2008
Update your record
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