MEDICARE: SHEENA KHANNA MD

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	207W00000X	Ophthalmology Physician	125.072336	IL
2	207W00000X	Ophthalmology Physician	036172735	IL
3	207W00000X	Ophthalmology Physician	A179181	CA

General Provider Information

NPI Number	:	1295127835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEENA KHANNA MD

Provider Business Mailing Address
First Line	:	2160 S 1ST AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-3328
Country	:	US
Telephone Number	:	708-216-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 STEIN PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3328
Country	:	US
Telephone Number	:	310-206-2380
Fax Number	:

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

Provider Enumeration Date	:	02/18/2015
Last Update Date	:	02/02/2026

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Directions to “ SHEENA KHANNA MD” Practice Location

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