Provider Demographics
NPI:1649430869
Name:KHALIL Y KARIM, MD, SC
Entity type:Organization
Organization Name:KHALIL Y KARIM, MD, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-450-7888
Mailing Address - Street 1:1111 SUPERIOR ST
Mailing Address - Street 2:STE 402
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-4138
Mailing Address - Country:US
Mailing Address - Phone:708-450-7788
Mailing Address - Fax:708-450-9464
Practice Address - Street 1:1111 SUPERIOR ST
Practice Address - Street 2:STE 402
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-4138
Practice Address - Country:US
Practice Address - Phone:708-450-7788
Practice Address - Fax:708-450-9464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH14203Medicare UPIN