Individual
DR. KHALID TALAL BANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4646 NORTH MARINE DRIVE, CHICAGO, IL 60640
(773) 564-5225
(773) 564-5226
Mailing address
333 E ONTARIO ST APT 2501B, CHICAGO, IL 60611-4879
(215) 327-0310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125.056746
IL
Other
Enumeration date
08/10/2009
Last updated
08/10/2009
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