Individual
DR. MOHAMMAD AWAD AL KHUDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1890 SILVER CROSS BLVD, SUITE 330, NEW LENOX, IL 60451-9508
(815) 717-6082
(815) 717-8693
Mailing address
1890 SILVER CROSS BLVD, SUITE 330, NEW LENOX, IL 60451-9508
(815) 717-6082
(815) 717-8693
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036051013
IL
207V00000X
Obstetrics & Gynecology Physician
3651013
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051013
—
IL
Enumeration date
11/16/2006
Last updated
05/01/2012
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