Individual
FAIZAN ALI KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
330 MADISON ST STE 200, JOLIET, IL 60435-6569
(630) 717-2600
(630) 718-2656
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
02004378A
IN
207RG0100X
Gastroenterology Physician
Primary
036-135062
IL
207RG0100X
Gastroenterology Physician
61636
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q00416546
RAILROAD MEDICARE
IN
Enumeration date
02/22/2011
Last updated
10/31/2023
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