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General NPI Number Information
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NPI Number | 1053683474
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE HEALTHCARE, PC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 2401 BROADWAY ST LOWER LEVEL
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City | PEKIN
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State | IL
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Zip | 61554-3905
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Country | US
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Telephone | 309-349-3175
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Fax | 309-620-8751
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Provider Business Mailing Address
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Address Line | 2401 BROADWAY ST LOWER LEVEL
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City | PEKIN
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State | IL
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Zip | 61554-3905
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Country | US
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Telephone | 309-349-3175
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Fax | 309-620-8751
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. JAMALUDDIN F AMANULLAH
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Credential | M.D.
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Telephone | 309-349-3175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 136127585
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License Number State | IL
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