Khdour, Adel
Khdour, Adel is an individual health care provider with primary practice located at 5333 Douglas Ave , Racine WI 53402-2032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Khdour, Adel can be contacted via phone (262) 752-2100.Contact Information
Primary practice address
5333 Douglas Ave
Racine WI 53402-2032
Phone: (262) 752-2100
Fax: (262) 752-2122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 81805 | Wisconsin |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036118811 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01064330A | Indiana |
Profile Details
| NPI number | 1083806384 |
|---|---|
| LBN Legal business name | Khdour, Adel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2007 |
| Last updated | Oct 16th, 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 | 1083806384 | NPPES |
| Wisconsin | MEDICAID | 100251357 | |
| Wisconsin | Other | 000000531548 | |
| Wisconsin | Other | 000001014115 | |
| Wisconsin | MEDICAID | 200876650 |
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