Provider Demographics
NPI:1518368026
Name:AREKAT, LOAI
Entity Type:Individual
Prefix:
First Name:LOAI
Middle Name:
Last Name:AREKAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 JOLIET ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1765
Mailing Address - Country:US
Mailing Address - Phone:219-865-3819
Mailing Address - Fax:219-865-5401
Practice Address - Street 1:2450 WOLF RD
Practice Address - Street 2:SUITE D
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5643
Practice Address - Country:US
Practice Address - Phone:708-483-7007
Practice Address - Fax:708-562-0129
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005203363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical