| M Raza Khan M D S C | |
|
1 S Virginia St Crystal Lake IL 60014-5826 | |
| (815) 893-7975 | |
| Not Available |
| Full Name | M Raza Khan M D S C |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 S Virginia St, Crystal Lake, Illinois |
| Authorized Official Name and Position | Mohammad Raza Khan (PRESIDENT) |
| Authorized Official Contact | 8474880123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M Raza Khan M D S C 450 Shepard Dr Suite 9 Elgin IL 60123-7033 Ph: (847) 488-0123 | M Raza Khan M D S C 1 S Virginia St Crystal Lake IL 60014-5826 Ph: (815) 893-7975 |
| NPI Number | 1881826253 |
|---|---|
| Provider Enumeration Date | 08/18/2009 |
| Last Update Date | 09/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881826253 | NPI | - | NPPES |
| 1801937545 | Other | PERSONAL NPI # | |
| 036118940 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036118940 (Illinois) | Primary |
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