Individual
KIRAN BHASKAR KHANOLKAR
Active
Individual
KIRAN BHASKAR KHANOLKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036147967
IL
207Q00000X
Family Medicine Physician
33370
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209202605
—
MO
01
—
33626
BLUE CROSS BLUE SHIELD
—
01
—
421527584
TRI-CARE GROUP NUMBER
—
05
—
421527584003
—
IL
01
—
42152758407
JOHN DEERE
—
05
—
O278374
—
IA
Enumeration date
05/27/2005
Last updated
11/10/2023
Update your record
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