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Individual

SHAHREQ ALI KHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BACHELOR OF SCIENCE

Contact information

Practice address
3949 GROVE AVE, GURNEE, IL 60031-2118
(224) 202-7777
Mailing address
3949 GROVE AVE, GURNEE, IL 60031-2118
(224) 202-7777

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
14D2250825
IL

Other

Enumeration date
12/15/2021
Last updated
02/08/2022
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