Individual
DR. RAZA M KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3 S GREENLEAF ST, SUITE J, GURNEE, IL 60031-3377
(847) 599-1111
(847) 599-1148
Mailing address
3 S GREENLEAF ST, SUITE J, GURNEE, IL 60031-3377
(847) 599-1111
(847) 599-1148
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036045549
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045549
—
IL
01
—
1635877
BCBS
—
Enumeration date
08/26/2005
Last updated
07/12/2019
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