Provider Demographics
NPI:1326072042
Name:KHAN, GHORI SIDDIQUE RASHIO (MD)
Entity Type:Individual
Prefix:DR
First Name:GHORI SIDDIQUE
Middle Name:RASHIO
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 1:8 HEALTH SERVICES DR
Mailing Address - Street 2:STE 5
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-9647
Mailing Address - Country:US
Mailing Address - Phone:815-754-0300
Mailing Address - Fax:815-754-0400
Practice Address - Street 1:8 HEALTH SERVICES DR
Practice Address - Street 2:STE 5
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-9647
Practice Address - Country:US
Practice Address - Phone:815-754-0300
Practice Address - Fax:815-754-0400
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
01932031OtherBCBS
01932031OtherBCBS
IL209291Medicare ID - Type Unspecified