Provider Demographics
NPI:1770561789
Name:ALKHALAFAWI, AMAL (MD)
Entity type:Individual
Prefix:
First Name:AMAL
Middle Name:
Last Name:ALKHALAFAWI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7613 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-1113
Mailing Address - Country:US
Mailing Address - Phone:708-583-9788
Mailing Address - Fax:708-583-9711
Practice Address - Street 1:7613 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-1113
Practice Address - Country:US
Practice Address - Phone:708-583-9788
Practice Address - Fax:708-583-9711
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31622539OtherBCBS
G63494Medicare UPIN
IL31622539OtherBCBS