Kherallah, Nizar

Kherallah, Nizar is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave Dept Of , Peoria IL 61637-2673. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as his primary health care specialty. Kherallah, Nizar can be contacted via phone (309) 624-9844.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Dept Of Peoria IL 61637-2673
Phone: (309) 624-9844
Fax: (309) 624-9844
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X 35072648 Ohio

Profile Details

NPI number 1669467726
LBN Legal business name Kherallah, Nizar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2005
Last updated Mar 17th, 2018 - about 8 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 1669467726 NPPES
Ohio MEDICAID 2122661

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