Individual
KIRAN BHASKAR KHANOLKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
640 W WASHINGTON ST, PITTSFIELD, IL 62363-1350
(217) 285-2113
Mailing address
640 W WASHINGTON ST, PITTSFIELD, IL 62363-1350
(217) 285-2113
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
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us