Provider Demographics
NPI:1194052829
Name:KHAN, RAFFAY (MD)
Entity type:Individual
Prefix:
First Name:RAFFAY
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E WOODFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4836
Mailing Address - Country:US
Mailing Address - Phone:847-605-0030
Mailing Address - Fax:847-637-0737
Practice Address - Street 1:804 E WOODFIELD RD STE 300
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4776
Practice Address - Country:US
Practice Address - Phone:847-605-9500
Practice Address - Fax:847-605-8700
Is Sole Proprietor?:No
Enumeration Date:2009-11-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143777207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036143777Medicaid
ILF400402524OtherMEDICARE PIN