Organization
2001-15 N PARKSIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONA KHAN DO (PHYSICIAN)
(312) 955-4005
Entity
Organization
Contact information
Practice address
405 N WABASH AVE STE P2-A, CHICAGO, IL 60611-3744
(312) 955-4005
Mailing address
18140 AUDETTE ST, DEARBORN, MI 48124-4217
(312) 998-5229
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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