Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036087263 | IL |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036.087263 | IL |
Y | 207RC0000X | Internist - Cardiovascular Disease | 036-087263 | IL |
NPI | 1730108804 |
---|---|
Provider Name | Nabil Al-Sharif |
First Address | Carbondale, IL 62902-3988 |
Second Address | Carbondale, IL 62901-1414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 17/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036087263 | (05) | IL |
G42381 | (02) | |
P00835872 | RAILROAD (01) | IL |