Provider Demographics
NPI:1003836107
Name:KHAN, ASADULLAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ASADULLAH
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD STE 7200
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2382
Mailing Address - Country:US
Mailing Address - Phone:847-618-4430
Mailing Address - Fax:847-618-0786
Practice Address - Street 1:880 W CENTRAL RD STE 7200
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2382
Practice Address - Country:US
Practice Address - Phone:847-618-4430
Practice Address - Fax:847-618-0786
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI657082080P0207X, 207RX0202X, 2084N0400X
IL036160478207RX0202X, 2080P0207X, 2084N0400X, 2084N0400X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1003836107Medicaid
VA010268087Medicaid
IL036160478OtherSTATE LICENSE
WIK400309547Medicare PIN
VA011538M93Medicare PIN
VAC03684Medicare PIN