Provider Demographics
NPI:1275855694
Name:ANWAR A. KHAN, M.D., LTD
Entity Type:Organization
Organization Name:ANWAR A. KHAN, M.D., LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-235-6867
Mailing Address - Street 1:4010 N ILLINOIS ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1967
Mailing Address - Country:US
Mailing Address - Phone:618-235-6867
Mailing Address - Fax:618-235-9732
Practice Address - Street 1:4010 N ILLINOIS ST STE 2
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1967
Practice Address - Country:US
Practice Address - Phone:618-235-6867
Practice Address - Fax:618-235-9732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty