Healthcare Provider Details

I. General information

NPI: 1457514879
Provider Name (Legal Business Name): AMIT KHIMAN PURSNANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CENTRAL ST STE 730
EVANSTON IL
60201
US

IV. Provider business mailing address

1000 CENTRAL ST STE 730
EVANSTON IL
60201-1779
US

V. Phone/Fax

Practice location:
  • Phone: 847-663-8410
  • Fax: 847-570-1865
Mailing address:
  • Phone: 847-663-8410
  • Fax: 847-570-1865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036136314
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: