Organization
KAHLON SURINDERPAL S
Active
Other names
EXAMMD CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
SURINDERPAL S KAHLON M.D. (PSYCHIATRIST)
(217) 497-9090
Entity
Organization
Contact information
Practice address
601 N LOGAN AVE, DANVILLE, IL 61832-4320
(217) 442-4055
(425) 795-5915
Mailing address
601 N LOGAN AVE, DANVILLE, IL 61832-4320
(217) 442-4055
(425) 795-5915
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036091614
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01058575A
LICENSE
IN
05
—
036091614
—
IL
01
—
09232010
BCBS
IL
01
—
36137-20
LICENSE
WI
Enumeration date
01/30/2012
Last updated
01/30/2012
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