MEDICARE: DR. LINDA L KHO 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	208000000X	Pediatrics Physician	94-07069	KS

General Provider Information

NPI Number	:	1699930784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA L KHO MD

Provider Business Mailing Address
First Line	:	3183 VENETIAN WAY
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-3454
Country	:	US
Telephone Number	:	224-805-7591
Fax Number	:

Provider Business Practice Location Address
First Line	:	3183 VENETIAN WAY
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-3454
Country	:	US
Telephone Number	:	224-805-7591
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	09/07/2011

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