Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 036.101208 | IL |
N | 207RI0200X | Infectious Disease | 9954 | ND |
NPI | 1043237035 |
---|---|
Provider Name | Abdulhamid Alkhalaf |
First Address | Dixon, IL 61021-3190 |
Second Address | Dixon, IL 61021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 17/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036101208 | (05) | IL |
I35722 | (02) |