DR. VIDITA VIJAY KHATRI (NPI# 1588072292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588072292 |
| Entity Type | Individual |
| Full Name | DR. VIDITA VIJAY KHATRI |
| Credential | MD |
| Practice Address |
375 N Wall St Ste P510 Kankakee IL 60901 |
| Mailing Address |
375 N Wall St Ste P510 Kankakee IL 60901-3492 |
| Practice Telephone | 8159350750 |
| Practice Fax Number | 8159358797 |
| Mailing Telephone | 8159350750 |
| Mailing Fax Number | 8159358797 |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MT207128 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
036147756 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 60 Fenwood Rd, Boston, MA 021156128 | 6177327432 | |
| 375 N Wall St Ste P510, Kankakee, IL 609013492 | 8159350750 | 8159358797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366817090 | Vidita Khatri | Physical Therapy Assistant | 4953 Schaefer Rd, Dearborn, MI 48126-3260 | 2015-12-07 |
| Street Address |
375 N WALL ST STE P510 |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053460634 | Kirsten L Mitchell | Psychologist | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2007-01-10 |
| 1780141234 | Morgan Taylor Willbarger | Nurse Practitioner | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2019-02-20 |
| 1629567185 | Stefanie Ann Lem | Psychologist | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2018-05-09 |
| 1811383755 | Shuja Sheikh | Psychiatry & Neurology | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2015-04-07 |
| 1932506458 | Pamela R Cook | Psychologist | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2014-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104088939 | Jimmy Viet Ninh | Psychiatry & Neurology | 375 N Wall St # 510, Kankakee, IL 60901-3483 | 2008-07-02 |
| 1013059005 | Bruce I Dodt | Psychiatry & Neurology | 500 N Wall St Ste 300, Kankakee, IL 60901-2942 | 2007-02-13 |
| 1811383755 | Shuja Sheikh | Psychiatry & Neurology | 375 N Wall St Ste P510, Kankakee, IL 60901-3492 | 2015-04-07 |
| 1811131055 | Simran Kaur Singh | Psychiatry & Neurology | 500 W Court St, Kankakee, IL 60901 | 2009-04-30 |
| 1831229574 | Neurology Ltd | Psychiatry & Neurology | 400 N Wall St, #507, Kankakee, IL 60901-2965 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831714294 | Kaitlin E Keenan | Psychiatry & Neurology | 600 S Paulina St Ste 403aac, Chicago, IL 60612-3806 | 2020-06-11 |
| 1811546484 | Glencor Neuromonitoring LLC | Psychiatry & Neurology | 611 S Milwaukee Ave Ste 8, Libertyville, IL 60048-3256 | 2019-09-06 |
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1972167906 | Kazkaz Southwest Neurology S.c. | Psychiatry & Neurology | 1890 Silver Cross Blvd Ste 320, New Lenox, IL 60451-9610 | 2019-04-25 |
| 1285195594 | Niccolo Emanuele Mencacci | Psychiatry & Neurology | 303 E Chicago Ave # 12-226, Chicago, IL 60611-4296 | 2019-03-28 |
| 1497216865 | Juan Pablo Ospina Botero | Psychiatry & Neurology | 5841 S Maryland Ave # 2030s231, Chicago, IL 60637-1443 | 2019-03-28 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1124526272 | Neurology Clinic of Chicago, LLC | Psychiatry & Neurology | 4909 W Division St Ste 302, Chicago, IL 60651-3161 | 2018-01-23 |
| 1538514120 | Kathleen Mary Gorman | Psychiatry & Neurology | 225 E Chicago Avenue, Chicago, IL 60611 | 2016-05-02 |
| 1396190203 | Lauren Brandes | Psychiatry & Neurology | 1725 W Harrison St Ste 309, Chicago, IL 60612-3844 | 2016-04-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.