Healthcare Provider Details

I. General information

NPI: 1982198271
Provider Name (Legal Business Name): NEHA KHEMANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E SUPERIOR ST FL 4
CHICAGO IL
60611-2914
US

IV. Provider business mailing address

430 MASON LN
LAKE IN THE HILLS IL
60156-4446
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-9451
  • Fax:
Mailing address:
  • Phone: 847-337-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036164067
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: