MEDICARE: KALIANA MEDICAL SERVICES, LTD

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	305R00000X	Preferred Provider Organization	036045238	IL

General Provider Information

NPI Number	:	1245497346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALIANA MEDICAL SERVICES, LTD

Provider Business Mailing Address
First Line	:	1952 E 73RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2902
Country	:	US
Telephone Number	:	773-493-5600
Fax Number	:	773-493-5790

Provider Business Practice Location Address
First Line	:	1952 E 73RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2902
Country	:	US
Telephone Number	:	773-493-5600
Fax Number	:	773-493-5790

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KUMAR M KALIANA
Credential	:	M.D.
Telephone Number	:	773-493-5600

Provider Enumeration Date	:	05/18/2008
Last Update Date	:	05/18/2008

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