Dr. Jeanne Marie Kairouz
Internist - Cardiovascular Disease
1770 E Lake Shore Dr Ste 105
Decatur
, Illinois 62521-3800
Dr. Jeanne Marie Kairouz
Internist - Cardiovascular Disease
1770 E Lake Shore Dr Ste 105
Decatur
, Illinois 62521-3800
(217) 422-6100
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Dr. Jeanne Marie Kairouz
- 1770 E Lake Shore Dr Ste 105
- Decatur, IL
- Zip : 62521-3800
- Phone : (217) 422-6100
Second Address
- Dr. Jeanne Marie Kairouz
- 1770 E Lake Shore Dr Ste 105
- Decatur, IL
- Zip : 62521-3800
- Phone : (217) 422-6100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0000X | Internist - Cardiovascular Disease | 0101245153 | VA |
| Y | 207RC0000X | Internist - Cardiovascular Disease | 036128746 | IL |
National Provider Identifier
| NPI | 1003846908 |
|---|---|
| Provider Name | Dr. Jeanne Marie Kairouz |
| First Address | Decatur, IL 62521-3800 |
| Second Address | Decatur, IL 62521-3800 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/07/2006 |
| Last Update Date | 22/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036128746 | (05) | IL |
| 1003846908 | VA MEDICAID (01) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.