Basic Information
Provider Information
NPI: 1437475548
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAHN
FirstName: ILANA
MiddleName: LEBEN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 MICHIGAN AVE NW
Address2: W3.5, 600
City: WASHINGTON
State: DC
PostalCode: 200102916
CountryCode: US
TelephoneNumber: 2024763670
FaxNumber: 2024764741
Practice Location
Address1: 111 MICHIGAN AVE NW
Address2: W3.5, 600
City: WASHINGTON
State: DC
PostalCode: 200102916
CountryCode: US
TelephoneNumber: 2024763670
FaxNumber: 2024764741
Other Information
ProviderEnumerationDate: 04/14/2010
LastUpdateDate: 08/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0402XMD040896DCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology

No ID Information.


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