Provider Demographics
NPI:1699374348
Name:SAIRA KHAN OD PLLC
Entity Type:Organization
Organization Name:SAIRA KHAN OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIRA
Authorized Official - Middle Name:NISHATH
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:630-276-6285
Mailing Address - Street 1:32406 FRANKLIN RD UNIT 250125
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-7004
Mailing Address - Country:US
Mailing Address - Phone:630-276-6285
Mailing Address - Fax:
Practice Address - Street 1:28804 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4235
Practice Address - Country:US
Practice Address - Phone:586-777-3434
Practice Address - Fax:586-777-6815
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAIRA KHAN OD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty