Provider Demographics
NPI:1245283043
Name:KHAN, JANINE YASMIN (MD)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:YASMIN
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BOX 45
Mailing Address - Street 2:CHILDRENS MEMORIAL HOSPITAL 2300 CHILDRENS PLAZA
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3394
Mailing Address - Country:US
Mailing Address - Phone:773-880-4142
Mailing Address - Fax:773-880-3061
Practice Address - Street 1:BOX 45
Practice Address - Street 2:CHILDRENS MEMORIAL HOSPITAL 2300 CHILDRENS PLAZA
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3394
Practice Address - Country:US
Practice Address - Phone:773-880-4142
Practice Address - Fax:773-880-3061
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H77059Medicare UPIN