Provider Demographics
NPI:1679218242
Name:AL KALAJI, BILAL (MD)
Entity Type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:AL KALAJI
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 1:4201, MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE A104
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050
Mailing Address - Country:US
Mailing Address - Phone:815-759-4726
Mailing Address - Fax:815-759-8255
Practice Address - Street 1:4201, MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE A104
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050
Practice Address - Country:US
Practice Address - Phone:815-759-4726
Practice Address - Fax:815-759-8255
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL125.080389207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program