Provider Demographics
NPI:1790090306
Name:LALANI, KHAIRUNISA M (NP)
Entity Type:Individual
Prefix:
First Name:KHAIRUNISA
Middle Name:M
Last Name:LALANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9977 WOODS DR
Mailing Address - Street 2:# 355
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1057
Mailing Address - Country:US
Mailing Address - Phone:847-663-8051
Mailing Address - Fax:847-663-8054
Practice Address - Street 1:9977 WOODS DR
Practice Address - Street 2:# 355
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1057
Practice Address - Country:US
Practice Address - Phone:847-663-8051
Practice Address - Fax:847-663-8054
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209008152363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner