Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301097521 | MI |
N | 111NI0900X | Internist | 4301097521 | MI |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 45187 | KY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 45187 | KY |
NPI | 1790967834 |
---|---|
Provider Name | Dr. Bassel Alkhalil |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40217-1363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2007 |
Last Update Date | 27/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0220066 | BCBS-MI (01) | MI |
201153470 | (05) | IN |
7100234090 | (05) | KY |