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General NPI Number Information
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NPI Number | 1063220085
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Entity Type | Individual
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Provider Name | LYNN KHOLOKI DDS
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Gender | Female
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2861 83RD ST
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City | DARIEN
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State | IL
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Zip | 60561-5612
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Country | US
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Telephone | 630-427-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 50 YORKTOWN SHOPPING CTR UNIT 464
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City | LOMBARD
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State | IL
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Zip | 60148-5649
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Country | US
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Telephone | 219-670-7759
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12014601A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019034931
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License Number State | IL
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