Individual
MAMATA KHANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1926 W HARRISON ST APT NO1400, CHICAGO, IL 60612-3737
(804) 873-3741
Mailing address
1926 W HARRISON ST APT NO1400, CHICAGO, IL 60612-3737
(804) 873-3741
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125065958
IL
Other
Enumeration date
06/29/2014
Last updated
06/29/2014
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