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1811656028
SHAHREQ ALI KHAN
GURNEE, IL
NPI
1811656028
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261Q00000X Clinic/Center
(Licence: IL 14D2250825)
Enumeration Date
2021-12-15
Last Update Date
2022-02-08
Business Address
SHAHREQ ALI KHAN BACHELOR OF SCIENCE
3949 GROVE AVE
GURNEE, IL 60031-2118
Phone number: 224-202-7777
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Mailing Address
SHAHREQ ALI KHAN BACHELOR OF SCIENCE
3949 GROVE AVE
GURNEE, IL 60031-2118
Phone number: 224-202-7777
Copy
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