1821443623 NPI number — MS. ANN KHIMANI N.P.

Table of content: MS. ANN KHIMANI N.P. (NPI 1821443623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821443623 NPI number — MS. ANN KHIMANI N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHIMANI
Provider First Name:
ANN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENDIS
Provider Other First Name:
ANN
Provider Other Middle Name:
L.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
N.P.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1821443623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2650 RIDGE AVE.
Provider Second Line Business Mailing Address:
DEPARTMENT OF EMERGENCY MEDICINE
Provider Business Mailing Address City Name:
EVANSTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-570-2114
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2650 RIDGE AVE.
Provider Second Line Business Practice Location Address:
DEPARTMENT OF EMERGENCY MEDICINE
Provider Business Practice Location Address City Name:
EVANSTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-570-2114
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  209013647041395610 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 209013647 . This is a "STATE LICENSE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 2015009621 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".