Individual
DR. FAREESA G KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1725 W HARRISON ST STE 1129, CHICAGO, IL 60612-3841
(312) 942-6613
Mailing address
1653 W CONGRESS PKWY # 230A, CHICAGO, IL 60612-3833
(312) 942-6613
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
112917
MO
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
036104448
IL
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
036-104448
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203820014
—
MO
Enumeration date
07/17/2006
Last updated
02/28/2022
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