MEDICARE: REHAM KHALIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629517966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REHAM KHALIL

Provider Business Mailing Address
First Line	:	8105 W LISBON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3826
Country	:	US
Telephone Number	:	414-212-8885
Fax Number	:

Provider Business Practice Location Address
First Line	:	8105 W LISBON AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-3826
Country	:	US
Telephone Number	:	414-212-8885
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2017
Last Update Date	:	02/20/2017

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Directions to “ REHAM KHALIL ” Practice Location

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