Provider Demographics
NPI:1629046735
Name:KHAN, AQEEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:AQEEL
Middle Name:A
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:DEPARTMENT 5973
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-5973
Mailing Address - Country:US
Mailing Address - Phone:630-924-1160
Mailing Address - Fax:630-924-1162
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:SUITE 110
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:630-924-1160
Practice Address - Fax:630-924-1162
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT687402084P0800X
IL036-1110212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111021-4Medicaid
IL214658 - K34765Medicare PIN
H78247Medicare UPIN
IL214675 - K34838Medicare PIN
IL214674 - K34837Medicare PIN