Provider Demographics
NPI:1538934161
Name:KHAN, NAYAB NOSHABA
Entity type:Individual
Prefix:
First Name:NAYAB
Middle Name:NOSHABA
Last Name:KHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N FREMONT ST APT 513
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2577
Mailing Address - Country:US
Mailing Address - Phone:443-960-6487
Mailing Address - Fax:
Practice Address - Street 1:1515 N FREMONT ST APT 513
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2577
Practice Address - Country:US
Practice Address - Phone:443-960-6487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician