Organization
SELF EMPOWERMENT CENTER, PC
Active
Other names
S.H.I.F.A.
Organization subpart
No
Provider details
NPI number
Authorized official
ASIF ALI KHAN PSYD (PRESIDENT)
(630) 774-8316
Entity
Organization
Contact information
Practice address
1751 SOUTH NAPERVILLE ROAD, SUITE #207, WHEATON, IL 60189
(630) 774-8316
(630) 690-3353
Mailing address
1751 SOUTH NAPERVILLE ROAD, SUITE #207, WHEATON, IL 60189
(630) 774-8316
(630) 690-3353
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623115
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/04/2007
Last updated
08/26/2008
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