# KOHLI & KHAN INTERNISTS MD SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770573651
- **Authorized official:** MANINDER S KOHLI M.D. (PRESIDENT)
- **Authorized official phone:** (708) 660-5017

## Contact information

- **Practice address:** 610 S MAPLE AVE, SUITE 3440, OAK PARK, IL 60304-1091
- **Practice address phone:** (708) 660-5017
- **Practice address fax:** (708) 660-5349
- **Mailing address:** PO BOX 399, MATTESON, IL 60443-0399
- **Mailing address phone:** (708) 747-5850
- **Mailing address fax:** (708) 747-9991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2005
- **Last updated:** 04/20/2008