Provider Demographics
NPI:1760094569
Name:KHAN, MAUREEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N LOMBARD ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1728
Mailing Address - Country:US
Mailing Address - Phone:630-269-1792
Mailing Address - Fax:
Practice Address - Street 1:1361 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-2153
Practice Address - Country:US
Practice Address - Phone:815-462-4273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist