AMANULLAH KHAN PATHAN MD NPI 1093749699

NPI Information

  • NPI: 1093749699
  • Provider Name: AMANULLAH KHAN PATHAN, MD
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Individual
  • Address: 4600 MEMORIAL DRIVE
    MEDICAL CENTER 2 SUITE 420
    BELLEVEILLE, IL
    ZIP 62226
  • Phone: (618) 239-3356

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NPI Details

Amanullah Khan Pathan, MD is a cardiovascular disease internal medicine in Belleveille, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Amanullah Khan Pathan, MD NPI is 1093749699. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4600 MEMORIAL DRIVE
MEDICAL CENTER 2 SUITE 420
BELLEVEILLE, IL
ZIP 62226-366
Phone: (618) 239-3356
Fax: (618) 239-3359

The enumeration date for this NPI number is 7/10/2006 and was last updated on 6/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular Disease036060909ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1060029745OTHERRR MEDICARE
2140491OTHERPHCS
3D14712OTHERMERCY HEALTH PLAN
4100789OTHERMISSOURIBCBS
52102754OTHERAETNA
6676430MEDICARE PIN
75095060029745OTHERCALIFORNIARR MEDICARE
8101463OTHERHEALTHLINK
92507179OTHERUHC
10D14712MEDICARE UPIN
11036060909MEDICAIDILLINOIS
127661OTHERGHP CMR
13146897XXOTHERPREFERRED CARE
1408200472OTHERILLINOISBCBS
150938287001OTHERCIGNA
161495152OTHERPENNSYLVANIABCBS
17P05754MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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