Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125067677 | IL |
N | 111NI0900X | Internist | 125067677 | IL |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01083044A | IN |
NPI | 1093197451 |
---|---|
Provider Name | Dr. Ali M Al Khazaali |
First Address | Merrillville, IN 46410-7032 |
Second Address | Munster, IN 46321-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 07/01/2022 |