MEDICARE: NITIN KHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	036085008	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DP2616	OTHER	IL	RAILROAD MEDICARE
2	P00742097	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	05620217	OTHER	IL	BCBS OF IL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063512325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NITIN KHER

Provider Business Mailing Address
First Line	:	PO BOX 787
Second Line	:
City	:	MCHENRY
State	:	IL
Zip	:	60051-9013
Country	:	US
Telephone Number	:	224-238-4160
Fax Number	:	847-214-9489

Provider Business Practice Location Address
First Line	:	690 E TERRA COTTA AVE STE A
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-3605
Country	:	US
Telephone Number	:	815-307-8075
Fax Number	:	815-344-4302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/15/2024

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Directions to “ NITIN KHER ” Practice Location

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