Provider Demographics
NPI:1235387085
Name:KHAN, SAKIB (MD)
Entity Type:Individual
Prefix:DR
First Name:SAKIB
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 1:1 EXECUTIVE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9533
Mailing Address - Country:US
Mailing Address - Phone:847-882-2030
Mailing Address - Fax:
Practice Address - Street 1:1 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9533
Practice Address - Country:US
Practice Address - Phone:847-882-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2021-01-21
Deactivation Date:2010-05-26
Deactivation Code:
Reactivation Date:2013-05-24
Provider Licenses
StateLicense IDTaxonomies
IL12055520207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine