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1306904131
RUSSELL I KHATER
JOLIET, IL
NPI
1306904131
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: IL 036098419)
Enumeration Date
2006-12-05
Last Update Date
2016-10-31
Business Address
Dr. RUSSELL I KHATER m.d.
1106 N LARKIN AVE LOWER LEVEL
JOLIET, IL 60435-3455
Phone number: 815-725-6188
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Mailing Address
Dr. RUSSELL I KHATER m.d.
1106 N LARKIN AVE LOWER LEVEL
JOLIET, IL 60435-3455
Phone number: 815-725-6188
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