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1475 E Oakton St Suite 2 Des Plaines IL 60018-2166 | |
| (224) 443-4988 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1475 E Oakton St, Des Plaines, Illinois |
| Authorized Official Name and Position | Hidayathulla Khan (PRESIDENT) |
| Authorized Official Contact | 2247669876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6147 Lincoln Ave Unit E Morton Grove IL 60053-2900 Ph: () - | 1475 E Oakton St Suite 2 Des Plaines IL 60018-2166 Ph: (224) 443-4988 |
| NPI Number | 1023549078 |
|---|---|
| Provider Enumeration Date | 03/22/2017 |
| Last Update Date | 03/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023549078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019030623 (Illinois) | Primary |
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