Healthcare Provider Details

I. General information

NPI: 1306976048
Provider Name (Legal Business Name): NABEEL RANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 N KNOXVILLE AVE HEARTCARE MIDWEST
PEORIA IL
61614
US

IV. Provider business mailing address

PO BOX 9382
PEORIA IL
61612-9382
US

V. Phone/Fax

Practice location:
  • Phone: 302-377-5663
  • Fax:
Mailing address:
  • Phone: 309-691-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC7-0002433
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number036.118672
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: