Healthcare Provider Details

I. General information

NPI: 1326178302
Provider Name (Legal Business Name): ALAN M NADOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALAA NADOUR MD

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 CROSSROADS BLVD
CARY NC
27518-6893
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 300
DOWNERS GROVE IL
60515-1069
US

V. Phone/Fax

Practice location:
  • Phone: 919-859-1276
  • Fax: 919-851-4519
Mailing address:
  • Phone: 630-725-2730
  • Fax: 844-205-5691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number036126312
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number201202254
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number201202254
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31392
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036126312
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number201202254
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: