Individual
MR. KHAI NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4600 MEMORIAL DRIVE, SUITE 280, BELLEVILLE, IL 62276-5366
(618) 257-2800
(618) 257-9802
Mailing address
4600 MEMORIAL DRIVE, SUITE 280, BELLEVILLE, IL 62276
(618) 257-2800
(618) 257-9802
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036079985
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079985
—
IL
Enumeration date
11/07/2006
Last updated
07/08/2007
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