Organization
KISHWAUKEE INTERNIST SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAUSHEEN ASMA KHAN (OFFICE MANAGER)
(815) 754-0300
Entity
Organization
Contact information
Practice address
2535 BETHANY RD, SUITE 201, SYCAMORE, IL 60178-3126
(815) 754-0300
(815) 754-0400
Mailing address
2535 BETHANY RD, SUITE 201, SYCAMORE, IL 60178-3126
(815) 754-0300
(815) 754-0400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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