Healthcare Provider Details

I. General information

NPI: 1164040366
Provider Name (Legal Business Name): WALEED SHAHEEN KHOKHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 SW MULVANE ST
TOPEKA KS
66606-1764
US

IV. Provider business mailing address

1950 W POLK ST FL 8
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-9591
  • Fax: 785-368-0467
Mailing address:
  • Phone: 312-864-7371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036.164245
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number04-53518
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036.164245
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number04-53518
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: