Antoun Al Khabbaz, MD | |
1200 W State St, Rockford, IL 61102-2112 | |
(815) 490-1600 | |
(815) 490-1485 |
Full Name | Antoun Al Khabbaz |
---|---|
Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 1200 W State St, Rockford, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992797260 | NPI | - | NPPES |
036116757 | Other | IL | ILLINOIS LICENSE |
64054091 | Medicaid | KY | |
336077827 | Other | IL | ILLINOIS CONTROLLED SUB |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207V00000X | Obstetrics & Gynecology | 37213 (Kentucky) | Secondary |
207V00000X | Obstetrics & Gynecology | 036116757 (Illinois) | Primary |
Entity Name | Crusaders Central Clinic Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1902972557 PECOS PAC ID: 5799682993 Enrollment ID: O20031216000642 |
Mailing Address | Practice Location Address |
---|---|
Antoun Al Khabbaz, MD 1200 W State St, Rockford, IL 61102-2112 Ph: (815) 490-1600 | Antoun Al Khabbaz, MD 1200 W State St, Rockford, IL 61102-2112 Ph: (815) 490-1600 |
Dr. Lester C Jurgens, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 2400 N Rockton Ave, Rockford, IL 61103 Phone: 815-971-5000 Fax: 815-968-9677 | |
Jamie Lynn Plett, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 6030 Garrett Ln, Rockford, IL 61107 Phone: 815-226-1172 Fax: 815-226-1595 | |
Kaneez Fatima Ali, MD Obstetrics & Gynecology Medicare: May Accept Medicare Assignments Practice Location: 3505 North Bell School Road, Rockford, IL 61114 Phone: 779-696-0300 | |
Dr. Bruce A Jasper, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 6861 Villagreen Vw, Rockford, IL 61107 Phone: 815-637-6200 | |
Ms. Lee Sesslar, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 3505 N. Bell School Rd., Rockford, IL 61114 Phone: 779-696-0300 | |
Mrs. Nicole Oluwabunmi Macaulay, M.D Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 5970 Churchview Dr, Rockford, IL 61107 Phone: 815-484-6398 Fax: 815-395-2021 | |
Sarah Bradley, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 779-696-4400 |