Provider Demographics
NPI:1790967834
Name:ALKHALIL, BASSEL (MD)
Entity type:Individual
Prefix:DR
First Name:BASSEL
Middle Name:
Last Name:ALKHALIL
Suffix:
Gender:
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-559-9529
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:3 AUDUBON PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1363
Practice Address - Country:US
Practice Address - Phone:502-636-8266
Practice Address - Fax:502-636-8260
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097521207R00000X, 208M00000X
KY45187207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100234090Medicaid
IN201153470Medicaid
MI0220066OtherBCBS-MI