Individual
MARIA KHATTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1836 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4030
(217) 789-1403
(217) 789-1825
Mailing address
1836 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4030
(217) 789-1403
(217) 789-1825
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036136594
IL
Other
Enumeration date
07/09/2012
Last updated
12/04/2015
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