Individual
BASSAM N MAALOUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
321 REGENCY PARK STE 100, O FALLON, IL 62269-1887
(618) 416-7970
(618) 416-7971
Mailing address
210 W MCKINLEY AVE STE 1, DECATUR, IL 62526-5858
(217) 329-3232
(217) 342-2074
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036133141
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036133141
—
IL
Enumeration date
10/04/2006
Last updated
03/25/2021
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