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General NPI Number Information
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NPI Number | 1306900493
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Entity Type | Organization
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Legal Business Name | SHEILENDR KHIPPLE MD
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 999 N ELMHURST RD 230
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City | MT PROSPECT
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State | IL
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Zip | 60056-1135
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Country | US
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Telephone | 847-670-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 999 N ELMHURST RD 230
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City | MT PROSPECT
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State | IL
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Zip | 60056-1135
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Country | US
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Telephone | 847-670-0800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHEILENDR KHIPPLE
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Credential | MD
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Telephone | 847-670-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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