Provider Demographics
NPI:1730282393
Name:ABDEL MEGUID, ALAA EL SAYED (MD)
Entity Type:Individual
Prefix:
First Name:ALAA
Middle Name:EL SAYED
Last Name:ABDEL MEGUID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WALL ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901
Mailing Address - Country:US
Mailing Address - Phone:815-937-9300
Mailing Address - Fax:815-937-9310
Practice Address - Street 1:500 N WALL ST
Practice Address - Street 2:SUITE 501
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901
Practice Address - Country:US
Practice Address - Phone:815-937-9300
Practice Address - Fax:815-937-9310
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1136097373207RI0011X
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04627231OtherBLUE CROSS BLUE SHIELD
IL631750Medicare ID - Type Unspecified
E40755Medicare UPIN