Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016005875 | IL |
N | 213ES0103X | Foot & Ankle Surgery | 07001263A | IN |
NPI | 1093133548 |
---|---|
Provider Name | Harpreet Khalsa |
First Address | Berwyn, IL 60402-3041 |
Second Address | Berwyn, IL 60402-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016005875 | LICENSE (01) | IL |