Lake Shore Ob Gyn Of Decatur S C in Decatur - Specialist
Lake Shore Ob Gyn Of Decatur S C - NPI 1700925583
Lake Shore Ob Gyn Of Decatur S C is a Specialist in Decatur, Illinois. Lake Shore Ob Gyn Of Decatur S C practices all healthcare services and medical treatments related to Specialist. The NPI Number for Lake Shore Ob Gyn Of Decatur S C is 1700925583. The last update date is 2013-07-25.
Lake Shore Ob Gyn Of Decatur S C's current location address is 1770 E Lake Shore Dr, Decatur, Illinois. You can contact this provider via phone number 2174294119 and fax number 2174290108. The mailing address for Lake Shore Ob Gyn Of Decatur S C is 1770 E Lake Shore Dr, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shore Ob Gyn Of Decatur S C |
|---|---|
| Address | 1770 E Lake Shore Dr, Decatur, Illinois |
| Phone Number | 2174294119 |
| Fax Number | 2174290108 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Hanna Samy Adel |
| Credentials | M.D. |
| Telephone Number | 2174294119 |
NPI Number Detail
| NPI Number | 1700925583 |
|---|---|
| Provider Enumeration Date | 2007-02-06 |
| Last Updated Date | 2013-07-25 |
Provider Mailing Address Detail
| Address | 1770 E Lake Shore Dr |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625213832 |
| Phone Number | 2174294119 |
| Fax Number | 2174290108 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 634112 | HEALTH LINK | ||
| 36110172 | IL | -- | |
| 5832038 | IL | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the Lake Shore Ob Gyn Of Decatur S C's 1700925583?
The Lake Shore Ob Gyn Of Decatur S C's NPI (National Provider Identifier) Number is 1700925583. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Lake Shore Ob Gyn Of Decatur S C is located?
The Lake Shore Ob Gyn Of Decatur S C is situated at the following address: 1770 E Lake Shore Dr, Decatur, IL, 625213832.
What is Lake Shore Ob Gyn Of Decatur S C's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lake Shore Ob Gyn Of Decatur S C's specialized field of practice is Specialist, and the corresponding taxonomy code that categorizes this area of specialization is 174400000X.
On what date did Lake Shore Ob Gyn Of Decatur S C receive its 1700925583 assignment from the Centers for Medicare & Medicaid Services?
The Lake Shore Ob Gyn Of Decatur S C was assigned its 1700925583 on 2007-02-06, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Lake Shore Ob Gyn Of Decatur S C most recently updated?
The details pertaining to the Lake Shore Ob Gyn Of Decatur S C, including its address, specialty, and other relevant information, were last refreshed on 2013-07-25.