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Individual

HOSAM N KHAYAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 492-2706
Mailing address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-5811
(217) 464-1318

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01065886A
IN
207R00000X
Internal Medicine Physician
036113434
IL
207RH0000X
Hematology (Internal Medicine) Physician
Primary
036113434
IL
208M00000X
Hospitalist Physician
01065886A
IN
208M00000X
Hospitalist Physician
036113434
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000612789
ANTHEM
IN
01
000000883080
ANTHEM
IN
05
036113434
IL
05
200926870
IN
Enumeration date
05/13/2006
Last updated
06/25/2025
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