Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 10422 | ND |
N | 207R00000X | Internist | 036109307 | IL |
N | 111NI0900X | Internist | 036109307 | IL |
N | 208000000X | Pediatrician | 036109307 | IL |
NPI | 1235157637 |
---|---|
Provider Name | Dr. Fatima Sultana Khan |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 11/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036109307 | (05) | IL |
G03057 | (02) | IL |
H86915 | (02) | IL |
N719075 | (02) | ND |