Marco N Khiella, MD | |
24 Joliet St, Dyer, IN 46311-1705 | |
(219) 865-2141 | |
(219) 933-2288 |
Full Name | Marco N Khiella |
---|---|
Gender | Male |
Speciality | Hospitalist |
Location | 24 Joliet St, Dyer, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215498118 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01090952A (Indiana) | Secondary |
207R00000X | Internal Medicine | 036161213 (Illinois) | Secondary |
208M00000X | Hospitalist | 01090952A (Indiana) | Primary |
Entity Name | Knd Development 59 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992034599 PECOS PAC ID: 3678602802 Enrollment ID: O20101021000962 |
Entity Name | Sound Physicians Of Illinois Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043598865 PECOS PAC ID: 1557533734 Enrollment ID: O20111012000272 |
Mailing Address | Practice Location Address |
---|---|
Marco N Khiella, MD Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Marco N Khiella, MD 24 Joliet St, Dyer, IN 46311-1705 Ph: (219) 865-2141 |
Jeannie Boram Ur, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 | |
Chao Gong, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-852-2502 | |
Dr. Harold Leroy Rahming, MD Hospitalist Medicare: Medicare Enrolled Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 | |
Dr. Chike Olisa Nwokolo, DO Hospitalist Medicare: Medicare Enrolled Practice Location: 24 Joliet St, Dyer, IN 46311 Phone: 219-865-2141 Fax: 219-933-2288 |