Individual
SUMBOL KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5219 W MADISON ST, CHICAGO, IL 60644-4152
(773) 378-4823
Mailing address
5219 W MADISON ST, CHICAGO, IL 60644-4152
(773) 378-4823
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85004005
IL
Other
Enumeration date
02/16/2011
Last updated
08/27/2013
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