Individual
DR. SANDEEP KHOSLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608
(773) 257-6452
Mailing address
3537 PAYSPHERE CIR, CHICAGO, IL 60674
(708) 786-2900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-083308
IL
207RC0000X
Cardiovascular Disease Physician
036083308
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-083308
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-083308-2
—
IL
Enumeration date
08/01/2005
Last updated
01/25/2011
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