Individual
WALID NASRI GHANTOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 S GREENLEAF ST, GURNEE, IL 60031-3369
(847) 446-3200
(847) 446-2934
Mailing address
343 RIDGE RD, WILMETTE, IL 60091-3251
(847) 446-3200
(847) 446-2934
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036-044591
IL
Other
Enumeration date
01/05/2006
Last updated
09/13/2012
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