Provider Demographics
NPI:1164479044
Name:AKL, YOUSSEF E (MD)
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:E
Last Name:AKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 E BOUGHTON RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440
Mailing Address - Country:US
Mailing Address - Phone:630-783-0044
Mailing Address - Fax:630-783-1961
Practice Address - Street 1:550 E BOUGHTON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440
Practice Address - Country:US
Practice Address - Phone:630-783-0044
Practice Address - Fax:630-783-1961
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09900513OtherBLUE CROSS BLUE SHIELD