Provider Demographics
NPI:1235191347
Name:KHARE, NARENDRA K (MD)
Entity Type:Individual
Prefix:
First Name:NARENDRA
Middle Name:K
Last Name:KHARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:STE 970
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-563-3447
Mailing Address - Fax:312-563-6617
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:STE 970
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-563-3447
Practice Address - Fax:312-563-6617
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6011208800000X
IL036132046208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200679702Medicaid
MO200679702Medicaid
MOC51286Medicare UPIN