Organization
M RAZA KHAN M D S C
Active
Organization
M RAZA KHAN M D S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD RAZA KHAN M D (PRESIDENT)
(847) 488-0123
Entity
Organization
Contact information
Practice address
1 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-5826
(815) 893-7975
Mailing address
450 SHEPARD DR, SUITE 9, ELGIN, IL 60123-7033
(847) 488-0123
(847) 488-0124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036118940
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118940
—
IL
01
—
1801937545
PERSONAL NPI #
—
Enumeration date
08/18/2009
Last updated
09/15/2009
Update your record
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