Most Relevant Information
Provider Data
| NPI Number: | 1003537739 |
| Provider Name: | KHADIJA MOTAN |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 085-010102 |
Most Important Dates
| Enumeration Date: | 09/09/2022 |
| Last Updated: | 12/29/2023 |
Provider Practice Location
2320 E 93RD ST
CHICAGO
IL
606173909
Practice Location Phone/Fax
| Phone: | 7739675430 |
| Fax: | 7739674205 |
Provider Mailing Location
29373 NETWORK PL
CHICAGO
IL
606731293
Provider Mailing Phone/Fax
| Phone: | 8473905900 |
| Fax: |