Individual
JORGE KATTAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Mailing address
200 E PENNSYLVANIA AVE, PEORIA, IL 61603-3089
(309) 624-4000
(309) 624-4010
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-096882
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096882
—
IL
Enumeration date
09/20/2006
Last updated
02/22/2016
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