Kairouz, Jeanne Marie
Kairouz, Jeanne Marie is an individual health care provider with primary practice located at 1770 E Lake Shore Dr Ste 105 , Decatur IL 62521-3800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Kairouz, Jeanne Marie can be contacted via phone (217) 422-6100.Contact Information
Primary practice address
1770 E Lake Shore Dr Ste 105
Decatur IL 62521-3800
Phone: (217) 422-6100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 0101245153 | Virginia |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036128746 | Illinois |
Profile Details
| NPI number | 1003846908 |
|---|---|
| LBN Legal business name | Kairouz, Jeanne Marie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2006 |
| Last updated | Dec 22nd, 2021 - about 4 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 | 1003846908 | NPPES |
| Virginia | Other | 1003846908 | VA MEDICAID |
| Virginia | MEDICAID | 036128746 | VA MEDICAID |
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