Provider Demographics
NPI:1710338355
Name:KHAN, SABRINA (OD)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WOODFIELD MALL
Mailing Address - Street 2:LENSCRAFTER D330
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5012
Mailing Address - Country:US
Mailing Address - Phone:847-619-9471
Mailing Address - Fax:
Practice Address - Street 1:5 WOODFIELD MALL
Practice Address - Street 2:LENSCRAFTER D330
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5012
Practice Address - Country:US
Practice Address - Phone:847-619-9471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046011019152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist