Provider Demographics
NPI:1144384165
Name:LAKHANI, ASHOK M (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:M
Last Name:LAKHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ASHOKKUMAR
Other - Middle Name:M
Other - Last Name:LAKHANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:424 N AUSTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2752
Mailing Address - Country:US
Mailing Address - Phone:708-848-9000
Mailing Address - Fax:
Practice Address - Street 1:816 COVENTRY LN
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1444
Practice Address - Country:US
Practice Address - Phone:630-990-2450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036056082Medicaid
IL602470Medicare ID - Type Unspecified
ILD89343Medicare UPIN