Individual
MR. SAMAR ALAM KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.080475
IL
2085R0001X
Radiation Oncology Physician
Primary
125.080475
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/22/2021
Last updated
03/12/2024
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