Individual
DR. NOOR A KHAISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3315 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-1000
(309) 344-2405
Mailing address
3315 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-1000
(309) 344-2405
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036060635
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008990
HEALTH ALLIANCE
IL
05
—
036060635
—
IL
01
—
07215152
BLUE CROSS
IL
01
—
100010089
RAILROAD MEDICARE
IL
01
—
169319
HEALTHLINK
IL
01
—
371221637
FEDERAL TAX IDENTIFICATIO
IL
01
—
5159329
AETNA HEALTH PLANS
IL
01
—
776530
MEDICARE GROUP NUMBER
IL
01
—
IL0110
JOHN DEERE
IL
Enumeration date
06/10/2006
Last updated
03/25/2015
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