Khan, Fareesa G

Khan, Fareesa G is an sole proprietor health care provider with primary practice located at 1725 W Harrison St Ste 1129 , Chicago IL 60612-3841. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. Khan, Fareesa G can be contacted via phone (312) 942-6613.

Contact Information

Primary practice address
1725 W Harrison St Ste 1129 Chicago IL 60612-3841
Phone: (312) 942-6613
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 112917 Missouri
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 036104448 Illinois
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 2088F0040X 036-104448 Illinois

Profile Details

NPI number 1790702322
LBN Legal business name Khan, Fareesa G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Feb 28th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790702322 NPPES
Missouri MEDICAID 203820014

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