Individual
KHLWD ABDELHAFEZ HASSAN KHTAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3017
Mailing address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036176061
IL
Other
Enumeration date
07/11/2022
Last updated
09/18/2025
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