Provider Demographics
NPI:1609891712
Name:ANIL K KHEMANI MD SC
Entity Type:Organization
Organization Name:ANIL K KHEMANI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHEMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-206-0025
Mailing Address - Street 1:2205 POINT BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-7840
Mailing Address - Country:US
Mailing Address - Phone:224-238-4160
Mailing Address - Fax:847-783-0599
Practice Address - Street 1:3703 DOTY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-7517
Practice Address - Country:US
Practice Address - Phone:815-206-0025
Practice Address - Fax:815-206-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091226207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05620217OtherBCBS
ILCK7752Medicare PIN
ILCK7751Medicare PIN
IL05620217OtherBCBS
IL981950Medicare PIN