Provider Demographics
NPI:1669434353
Name:KHER, ANJALI (MD SC)
Entity type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:
Last Name:KHER
Suffix:
Gender:F
Credentials:MD SC
Other - Prefix:DR
Other - First Name:ANJALI
Other - Middle Name:A
Other - Last Name:PETHKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD SC
Mailing Address - Street 1:PO BOX 9200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-0200
Mailing Address - Country:US
Mailing Address - Phone:815-609-3627
Mailing Address - Fax:815-609-1328
Practice Address - Street 1:13415 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-5676
Practice Address - Country:US
Practice Address - Phone:815-609-3627
Practice Address - Fax:815-609-1328
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104529208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932022OtherBLUE CROSS BLUE SHIELD
IL036104529Medicaid
IL769437OtherAETNA
ILH58338Medicare UPIN