Kahwaji, Michael Patrick

Kahwaji, Michael Patrick is an individual health care provider with primary practice located at 2502 B East Empire , Bloomington IL 61704. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Kahwaji, Michael Patrick can be contacted via phone (309) 663-7220.

Contact Information

Primary practice address
2502 B East Empire Bloomington IL 61704
Fax: (309) 664-6687
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1679509806
LBN Legal business name Kahwaji, Michael Patrick
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679509806 NPPES
Illinois Other 044404 HEALTH ALLIANCE

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