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NPI 1598825366

NPI 1598825366 : MOURICE S NEMRI M.D. : NEW LENOX, IL

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General NPI Number Information
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    NPI Number           |    1598825366
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    Entity Type          |    Individual 
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    Provider Name        |    MOURICE S NEMRI M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2006
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    Last Update Date     |    12/08/2021
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Provider Practice Location Address
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    Address Line         |    100 BATSON CT SUITE 106
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    City                 |    NEW LENOX
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    State                |    IL
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    Zip                  |    60451-1564
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    Country              |    US
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    Telephone            |    815-463-9747
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    Fax                  |    815-463-9749
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Provider Business Mailing Address
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    Address Line         |    100 BATSON CT SUITE 106
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    City                 |    NEW LENOX
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    State                |    IL
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    Zip                  |    60451-1564
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    Country              |    US
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    Telephone            |    815-463-9747
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    Fax                  |    815-463-9749
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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        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    036065703
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    License Number State |    IL
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