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1659831501
BASSIL KHERALLAH
PEORIA, IL
NPI
1659831501
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: 90200000x)
Enumeration Date
2019-03-25
Last Update Date
2019-03-25
Business Address
Dr. BASSIL KHERALLAH MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-624-4000
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Mailing Address
Dr. BASSIL KHERALLAH MD
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-624-4000
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