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Individual

DR. MOHAMMAD KAMRAN KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1890 SILVER CROSS BLVD, NEW LENOX, IL 60451
(815) 723-4387
(815) 723-4634
Mailing address
1890 SILVER CROSS BLVD, NEW LENOX, IL 60451-9518
(815) 723-4387
(815) 723-4634

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036121940
IL
207T00000X
Neurological Surgery Physician
20A11564
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036121940
IL
01
206147
MEDICARE (GROUP)
IL
01
206147203
MEDICARE (INDIVIDUAL)
IL
Enumeration date
09/15/2010
Last updated
09/04/2018
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