Dabash, Khaled A

Dabash, Khaled A is an individual health care provider with primary practice located at 515 E Grant St , Macomb IL 61455-3368. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Dabash, Khaled A can be contacted via phone (309) 836-5437.

Contact Information

Primary practice address
515 E Grant St Macomb IL 61455-3368
Phone: (309) 836-5437
Fax: (309) 836-5417
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036089170 Illinois

Profile Details

NPI number 1114922044
LBN Legal business name Dabash, Khaled A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jul 15th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114922044 NPPES
Illinois Other 5522926 BLUE CROSS/BLUE SHIELD
Illinois Other 010060 BLUE CROSS/BLUE SHIELD
Illinois MEDICAID 036089170 BLUE CROSS/BLUE SHIELD

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