Provider Demographics
NPI:1750669354
Name:EL BITAR, YOUSSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:
Last Name:EL BITAR
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 1:20733 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CARLINVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62626-3710
Mailing Address - Country:US
Mailing Address - Phone:217-545-8000
Mailing Address - Fax:217-854-6462
Practice Address - Street 1:20733 N BROAD ST
Practice Address - Street 2:
Practice Address - City:CARLINVILLE
Practice Address - State:IL
Practice Address - Zip Code:62626-3710
Practice Address - Country:US
Practice Address - Phone:217-545-8000
Practice Address - Fax:217-854-6462
Is Sole Proprietor?:No
Enumeration Date:2011-07-30
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-138988207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036138988Medicaid
ILF400277177Medicare PIN