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General NPI Number Information
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NPI Number | 1821612185
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Entity Type | Individual
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Provider Name | ISLAM KHALED HUSSEIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 02/01/2026
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Provider Practice Location Address
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Address Line | 1200 S 1ST AVE
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City | HINES
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State | IL
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Zip | 60141-0800
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Country | US
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Telephone | 708-338-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 CHATHAM RD # 4924
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City | SPRINGFIELD
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State | IL
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Zip | 62704-4188
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Country | US
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Telephone | 773-854-4179
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Fax | 708-894-4335
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 125076912
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036161227
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License Number State | IL
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