Al Khabbaz, Antoun
Al Khabbaz, Antoun is an sole proprietor health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Al Khabbaz, Antoun can be contacted via phone (815) 490-1600.Contact Information
Primary practice address
1200 W State St
Rockford IL 61102-2112
Phone: (815) 490-1600
Fax: (815) 490-1485
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 37213 | Kentucky |
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 036116757 | Illinois |
Profile Details
NPI number | 1992797260 |
---|---|
LBN Legal business name | Al Khabbaz, Antoun |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 22nd, 2005 |
Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992797260 | NPPES |
Illinois | Other | 036116757 | ILLINOIS LICENSE |
Illinois | MEDICAID | 64054091 | ILLINOIS LICENSE |
Illinois | Other | 336077827 | ILLINOIS LICENSE |
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