Provider Demographics
NPI:1952729782
Name:KHANNA, SUCHIN RAJEEV (MD)
Entity Type:Individual
Prefix:
First Name:SUCHIN
Middle Name:RAJEEV
Last Name:KHANNA
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 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:3745 HIGHLAND AVE FL 2
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1584
Practice Address - Country:US
Practice Address - Phone:630-275-2300
Practice Address - Fax:630-369-1560
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD469974207RH0003X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology