Provider Demographics
NPI:1306253349
Name:KHAN, SALMAN ALI (MD)
Entity type:Individual
Prefix:
First Name:SALMAN ALI
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 1:4309 W MEDICAL CENTER DR STE B301
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8439
Mailing Address - Country:US
Mailing Address - Phone:847-535-6083
Mailing Address - Fax:847-234-4336
Practice Address - Street 1:4309 W MEDICAL CENTER DR STE B301
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8439
Practice Address - Country:US
Practice Address - Phone:847-535-6083
Practice Address - Fax:847-234-4336
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47761207RG0100X
MO2014016485390200000X
IL036168575207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program