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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992797260 NPPES
Illinois Other 036116757 ILLINOIS LICENSE
Illinois MEDICAID 64054091 ILLINOIS LICENSE
Illinois Other 336077827 ILLINOIS LICENSE

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