Individual
NIZAR N MERHEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11825 STATE ROUTE 40, DUNLAP, IL 61525-8842
(309) 243-8980
Mailing address
10705 N ALEX DR, PEORIA, IL 61615-1167
(309) 868-2525
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021002096
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
036111888
IL
Other
Enumeration date
03/09/2007
Last updated
08/24/2007
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