Individual
ANJUM F KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4753 N BROADWAY ST STE 403, CHICAGO, IL 60640-7910
(773) 989-2780
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277-001490
IL
363LF0000X
Family Nurse Practitioner
14955
WI
363LF0000X
Family Nurse Practitioner
277001490
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
14955-33
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277001490
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100271382
—
WI
Enumeration date
02/06/2015
Last updated
04/06/2026
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