=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932628336
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GHEITH MEDICAL BILLING & REVENUE CYCLE MANAGEMENT ENTERPRISE LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2017
-----------------------------------------------------
Last Update Date | 09/26/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9412 SAYRE AVE
-----------------------------------------------------
City | OAK LAWN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60453-2058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-646-1790
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9412 SAYRE AVE
-----------------------------------------------------
City | OAK LAWN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60453-2058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. HANA GHEITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 708-646-1790
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246YC3302X
-----------------------------------------------------
Taxonomy Name | Physician Office Based Coding Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------