Individual
DR. KINAN J ABOU-KASSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 814-5178
Mailing address
800 E CARPENTER STREET BOX 43, SPRINGFIELD, IL 62769-0001
(217) 814-5178
(217) 757-6458
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2021022427
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
04/07/2020
Last updated
03/16/2022
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