Provider Demographics
NPI:1205872405
Name:KHAN, ZAKA URREHMAN (MD)
Entity type:Individual
Prefix:DR
First Name:ZAKA
Middle Name:URREHMAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:100 W MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1332
Practice Address - Country:US
Practice Address - Phone:502-587-8000
Practice Address - Fax:502-583-8001
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36009207RP1001X, 207RC0200X, 207RS0012X
IN01063137A207RP1001X, 207RS0012X
MO2004036407207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64042112Medicaid
IN200863930Medicaid
KYH41282Medicare UPIN
KY64042112Medicaid
KY0555515Medicare PIN
P00396297Medicare PIN