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General NPI Number Information
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NPI Number | 1962604983
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Entity Type | Organization
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Legal Business Name | WILL COUNTY OB GYN LTD
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1114 N LARKIN AVE
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City | JOLIET
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State | IL
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Zip | 60435-3435
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Country | US
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Telephone | 815-725-6188
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Fax | 815-741-1541
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Provider Business Mailing Address
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Address Line | 1114 N LARKIN AVE
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City | JOLIET
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State | IL
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Zip | 60435-3435
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Country | US
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Telephone | 815-725-6188
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Fax | 815-741-1541
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMIN KHATER
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Credential | MD
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Telephone | 815-725-6188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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