Individual
DR. ANWAR A KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4010 NORTH ILLINOIS STREET, STE 2, BELLEVILLE, IL 62226
(618) 235-6867
(618) 235-9732
Mailing address
4010 NORTH ILLINOIS STREET, STE 2, BELLEVILLE, IL 62226
(618) 235-6867
(618) 235-9732
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036061962
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008200468
BLUE CROSS BLUE SHIELD
IL
05
—
036061962
—
IL
01
—
13474
ESSENCE
IL
01
—
259401
HARMONY HEALTH CARE
IL
Enumeration date
09/13/2006
Last updated
02/12/2010
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