| Dr Mohammed Ali Khan, MD | |
|
3212 Court St, Pekin, IL 61554-6209 | |
| (309) 306-1234 | |
| (309) 213-9661 |
| Full Name | Dr Mohammed Ali Khan |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 3212 Court St, Pekin, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396953485 | NPI | - | NPPES |
| 09015685 | Other | IL | BCBS OF IL |
| 036123108 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | 036123108 (Illinois) | Secondary |
| 208000000X | Pediatrics | 036123108 (Illinois) | Primary |
| Entity Name | Freeport Regional Health Care Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457337016 PECOS PAC ID: 9234041682 Enrollment ID: O20031104000182 |
| Entity Name | Decatur Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164477725 PECOS PAC ID: 6204731144 Enrollment ID: O20031203000685 |
| Entity Name | Sarah Bush Lincoln Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669564662 PECOS PAC ID: 5092614867 Enrollment ID: O20031231000478 |
| Entity Name | Southern Illinois Medical Services Nfp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mohammed Ali Khan, MD 3212 Court St, Pekin, IL 61554-6209 Ph: (309) 306-1234 | Dr Mohammed Ali Khan, MD 3212 Court St, Pekin, IL 61554-6209 Ph: (309) 306-1234 |
Ann Parkin-cohen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3422 Court St, Pekin, IL 61554 Phone: 309-680-7600 Fax: 309-495-6698 | |
Dr. Ashley Fischer, M.D, Pediatrics Medicare: Medicare Enrolled Practice Location: 3223 Griffin Ave, Pekin, IL 61554 Phone: 309-353-1822 | |
Reginald Bowman, Pediatrics Medicare: Medicare Enrolled Practice Location: 600 S 13th St, Ste A, Pekin, IL 61554 Phone: 309-347-2191 Fax: 309-347-4821 |