Individual
DR. FAZAL KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10350 HALIGUS RD, HUNTLEY, IL 60142-9558
(815) 338-6600
(847) 802-7203
Mailing address
13707 W JACKSON ST, WOODSTOCK, IL 60098-3188
(815) 337-1871
(815) 338-6297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036104590
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080195055
MEDICARE RAILROAD
IL
Enumeration date
05/02/2006
Last updated
04/24/2009
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