Healthcare Provider Details

I. General information

NPI: 1285803791
Provider Name (Legal Business Name): PERFECT MANAGED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4527 N PULASKI RD
CHICAGO IL
60630-4415
US

IV. Provider business mailing address

4527 N PULASKI RD
CHICAGO IL
60630-4415
US

V. Phone/Fax

Practice location:
  • Phone: 773-267-7060
  • Fax: 773-267-4752
Mailing address:
  • Phone: 773-267-7060
  • Fax: 773-267-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHANDRA M KHURANA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 773-267-7060