Individual
SAMINA NIAZ KHATTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3903 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-2555
(219) 398-7050
(219) 392-6998
Mailing address
8400 LOUISIANA ST, MERRILLVILLE, IN 46410-6385
(219) 757-1928
(219) 757-1950
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01057204A
IN
2084P0800X
Psychiatry Physician
Primary
036-096202
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000272808
ANTHEM BCBS
IN
05
—
200424330
—
IN
Enumeration date
08/15/2005
Last updated
04/26/2021
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