Altwal, Shadi Adel
Altwal, Shadi Adel is an individual health care provider with primary practice located at 4500 Memorial Dr , Belleville IL 62226. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Altwal, Shadi Adel can be contacted via phone (618) 257-6220.Contact Information
Primary practice address
4500 Memorial Dr
Belleville IL 62226
Phone: (618) 257-6220
Fax: (618) 257-6679
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036-112737 | Illinois |
Profile Details
| NPI number | 1417992520 |
|---|---|
| LBN Legal business name | Altwal, Shadi Adel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Jan 29th, 2021 - about 3 years ago |
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 | 1417992520 | NPPES |
| Illinois | Other | 106079 | HEALTH ALLIANCE |
| Illinois | MEDICAID | 036112737 | HEALTH ALLIANCE |
| Illinois | Other | 08726591 | HEALTH ALLIANCE |
| Illinois | Other | 717755 | HEALTH ALLIANCE |
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