MEDICARE: DR. RAHEEL KHATRI D.M.D

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	1223G0001X	General Practice Dentistry	019032432	IL

General Provider Information

NPI Number	:	1376942383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAHEEL KHATRI D.M.D

Provider Business Mailing Address
First Line	:	4709 GOLF RD STE 1005
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-1260
Country	:	US
Telephone Number	:	847-677-2404
Fax Number	:

Provider Business Practice Location Address
First Line	:	4709 GOLF RD STE 1005
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-1260
Country	:	US
Telephone Number	:	847-677-2404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2014
Last Update Date	:	04/11/2026

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