Basic Information
| Provider Information | |||||||||
| NPI: | 1063512325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KHER | ||||||||
| FirstName: | NITIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 787 | ||||||||
| Address2: | |||||||||
| City: | MCHENRY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600519013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2242384160 | ||||||||
| FaxNumber: | 8472149489 | ||||||||
| Practice Location | |||||||||
| Address1: | 661 RIDGEVIEW DR | ||||||||
| Address2: | |||||||||
| City: | MCHENRY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600507012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8153078075 | ||||||||
| FaxNumber: | 8153078091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 12/06/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 036085008 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 036085008 | 05 | IL | MEDICAID | P00742097 | 01 | IL | RAILROAD MEDICARE | OTHER | 05620217 | 01 | IL | BCBS OF IL | OTHER | DP2616 | 01 | IL | RAILROAD MEDICARE | OTHER |