Individual
DR. MOHAMMED NASIR KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 BIESTERFIELD RD STE G01, WIMMER BUILDING, ELK GROVE VILLAGE, IL 60007-3372
(847) 981-3680
(847) 956-5122
Mailing address
900 S FRONTAGE RD, SUITE 325, WOODRIDGE, IL 60517-4903
(847) 981-3680
(847) 956-5122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-116767
IL
207RC0000X
Cardiovascular Disease Physician
036-116767
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036-116767
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720371669
NPI GROUP PRACTICE
IL
01
—
IL6304018
MEDICARE PTAN LOC 16
IL
01
—
IL6305018
MEDICARE PTAN LOC 15
IL
01
—
P01013360
RRMC PTAN
IL
Enumeration date
04/18/2007
Last updated
01/29/2013
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