Kherallah, Nizar
Kherallah, Nizar is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave Dept Of , Peoria IL 61637-2673. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as his primary health care specialty. Kherallah, Nizar can be contacted via phone (309) 624-9844.Contact Information
Primary practice address
530 Ne Glen Oak Ave Dept Of
Peoria IL 61637-2673
Phone: (309) 624-9844
Fax: (309) 624-9844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | 35072648 | Ohio |
Profile Details
| NPI number | 1669467726 |
|---|---|
| LBN Legal business name | Kherallah, Nizar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Mar 17th, 2018 - about 7 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 | 1669467726 | NPPES |
| Ohio | MEDICAID | 2122661 |
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