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NPI Code Detail

MEDICARE: ANDRIY KHLOPAS NP

MEDICARE: ANDRIY KHLOPAS NP
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
1363L00000XNurse Practitioner99083662AIN
2363L00000XNurse Practitioner277.000785IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598263899
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRIY KHLOPAS NP
Provider Business Mailing Address
First Line : 3412 W. FULLERTON .AVE.
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2416
Country : US
Telephone Number : 773-235-8000
Fax Number : 773-486-9320
Provider Business Practice Location Address
First Line : 3412 W. FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2416
Country : US
Telephone Number : 773-235-8000
Fax Number : 773-486-9320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 04/06/2022

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Directions to “ ANDRIY KHLOPAS NP” Practice Location

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