Provider Demographics
NPI:1861434896
Name:KHAN, FARAH N (MD)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:N
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S MICHIGAN AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3205
Mailing Address - Country:US
Mailing Address - Phone:312-977-1185
Mailing Address - Fax:312-977-1185
Practice Address - Street 1:7400 E ORCHARD RD STE 1000N
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2530
Practice Address - Country:US
Practice Address - Phone:720-928-5446
Practice Address - Fax:312-977-1185
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0060464207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH67216Medicare UPIN