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Individual

MONTHER F EL BZOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
215 E 1ST ST, STE 214, DIXON, IL 61021
(815) 285-5678
(815) 285-5898
Mailing address
215 E 1ST ST, STE 214, DIXON, IL 61021-3166
(815) 285-5853
(815) 285-5573

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-104657
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036104657
IL
01
K15959
MEDICARE
IL
Enumeration date
01/27/2006
Last updated
12/11/2024
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