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General NPI Number Information
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NPI Number | 1255659587
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Entity Type | Individual
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Provider Name | MOHANNAD RAJJOUB MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 200 E FAIRMAN AVE
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City | WATSEKA
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State | IL
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Zip | 60970-1644
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Country | US
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Telephone | 815-432-5841
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E FAIRMAN AVE
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City | WATSEKA
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State | IL
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Zip | 60970-1644
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Country | US
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Telephone | 815-432-7775
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Fax | 815-432-7722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01098483A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01098483A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301092218
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036-118894
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License Number State | IL
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