Healthcare Provider Details

I. General information

NPI: 1730282393
Provider Name (Legal Business Name): ALAA EL SAYED ABDEL MEGUID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N WALL ST SUITE 501
KANKAKEE IL
60901
US

IV. Provider business mailing address

500 N WALL ST SUITE 501
KANKAKEE IL
60901
US

V. Phone/Fax

Practice location:
  • Phone: 815-937-9300
  • Fax: 815-937-9310
Mailing address:
  • Phone: 815-937-9300
  • Fax: 815-937-9310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number1136097373
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: