MEDICARE: JI NA KHANANISHO FNP

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	363LF0000X	Family Nurse Practitioner	041464552	IL

General Provider Information

NPI Number	:	1437812203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JI NA KHANANISHO FNP

Provider Business Mailing Address
First Line	:	PO BOX 3603
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60522-3603
Country	:	US
Telephone Number	:	773-772-7858
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 W DIVISION ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2853
Country	:	US
Telephone Number	:	773-772-7858
Fax Number	:

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

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	09/02/2022

Similar Medicare Providers

1679545503 — MAIN PROFESSIONAL PHARMACY
Practice Location Address:

2736 W DIVISION ST
CHICAGO, IL
60622-2853

Practice Phone: 773-276-2372
Practice Fax: 773-276-2710

1558398388 — ERIC MIZUNO M.D.
Practice Location Address:

2720 W DIVISION ST
CHICAGO, IL
60622-2853

Practice Phone: 773-523-8600
Practice Fax: 773-687-9545

1376632976 — DR. VIVEK GUPTA M.D.
Practice Location Address:

2720 W DIVISION ST
CHICAGO, IL
60622-2853

Practice Phone: 773-523-8600
Practice Fax: 773-687-9545

1033300694 — VIVEK GUPTA, M.D., S.C.
Practice Location Address:

2720 W DIVISION ST
CHICAGO, IL
60622-2853

Practice Phone: 773-523-8600
Practice Fax: 773-687-9545

1487987814 — DR. JOHANN SEBASTIAN JC REYES SERAG MD
Practice Location Address:

2720 DIVISON ST
CHICAGO, IL
60622-2853

Practice Phone: 773-523-8600
Practice Fax:

1518213537 — DR. GAURIKA MEHRA MD
Practice Location Address:

2720 W DIVISION ST
CHICAGO, IL
60622-2853

Practice Phone: 773-772-7858
Practice Fax: 773-276-6668

Directions to “ JI NA KHANANISHO FNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.