Khan, Ejaz Ahmed

Khan, Ejaz Ahmed is an individual health care provider with primary practice located at 3922 Mercy Dr , Mchenry IL 60050-3179. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Khan, Ejaz Ahmed can be contacted via phone (815) 578-2020.

Contact Information

Primary practice address
3922 Mercy Dr Mchenry IL 60050-3179
Phone: (815) 578-2020
Fax: (815) 344-3241
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036108886 Illinois

Profile Details

NPI number 1518902527
LBN Legal business name Khan, Ejaz Ahmed
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Sep 30th, 2015 - about 9 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 1518902527 NPPES
Illinois Other 1619414 BCBS GROUP
Illinois MEDICAID 3633309286030501 BCBS GROUP
Illinois MEDICAID 036108886 BCBS GROUP

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