MEDICARE: PERFECT MANAGED CARE LLC

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	171W00000X	Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285803791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFECT MANAGED CARE LLC

Provider Business Mailing Address
First Line	:	4527 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4415
Country	:	US
Telephone Number	:	773-267-7060
Fax Number	:	773-267-4752

Provider Business Practice Location Address
First Line	:	4527 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4415
Country	:	US
Telephone Number	:	773-267-7060
Fax Number	:	773-267-4752

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. CHANDRA M KHURANA
Credential	:	M.D.
Telephone Number	:	773-267-7060

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	02/28/2008

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