Organization
SOUTHERN ILLINOIS RESPIRATORY DISEASE CONSULTANTS, LLC
Active
Organization
SOUTHERN ILLINOIS RESPIRATORY DISEASE CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUHAIL ISTANBOULY M.D. (PRESIDENT)
(618) 942-7402
Entity
Organization
Contact information
Practice address
317 S 14TH ST, SUITE 3, HERRIN, IL 62948-3671
(618) 942-7402
Mailing address
317 S 14TH ST, SUITE 3, HERRIN, IL 62948-3671
(618) 942-7402
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036098950
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098950
—
IL
Enumeration date
07/16/2008
Last updated
11/04/2008
Update your record
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