Individual
DR. NAFEES KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2512 HURST DR STE 130, MATTOON, IL 61938-9200
(217) 258-5900
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
(217) 902-5291
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036096917
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096917
—
IL
01
—
99106
WELLMARK
—
01
—
P00469958
RR MEDICARE
IL
Enumeration date
09/19/2005
Last updated
12/12/2019
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