MEDICARE: MAYA FAMILY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician		IL
2	2080P0208X	Pediatric Infectious Diseases Physician		IL

General Provider Information

NPI Number	:	1043424450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYA FAMILY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	4527 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630
Country	:	US
Telephone Number	:	773-267-6617
Fax Number	:	773-267-0460

Provider Business Practice Location Address
First Line	:	4527 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630
Country	:	US
Telephone Number	:	773-267-6617
Fax Number	:	773-267-0460

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CHANDRA MOHINI KHURANA
Credential	:	MD
Telephone Number	:	773-267-6617

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	09/11/2025

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Directions to “MAYA FAMILY MEDICAL CENTER ” Practice Location

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