Provider Demographics
NPI:1013208537
Name:AKG MEDICAL SERVICE CORPORATION
Entity Type:Organization
Organization Name:AKG MEDICAL SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ATIKA
Authorized Official - Middle Name:TAMKANAT
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-281-8855
Mailing Address - Street 1:3403 W THORNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3405
Mailing Address - Country:US
Mailing Address - Phone:773-281-8855
Mailing Address - Fax:773-281-5867
Practice Address - Street 1:8344 CONCORD DR
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2234
Practice Address - Country:US
Practice Address - Phone:773-281-8855
Practice Address - Fax:773-281-5867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty