RAED AL-DALLOW (NPI# 1164572095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164572095 |
| Entity Type | Individual |
| Full Name | RAED AL-DALLOW |
| Credential | M.D. |
| Practice Address |
409 W Oak St Carbondale IL 62901-1464 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185294455 |
| Practice Fax Number | 6183511287 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036106632 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
036106632 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD | 00390550 | 01 |
| IL | 036106632 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Dr Warren Tuttle Dr, Harrisburg, IL 629462718 | 6185294455 | 6183511287 |
| 5383 State Route 154, Pinckneyville, IL 622743342 | 6185294455 | 6183511287 |
| Street Address |
409 W OAK ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445975 | Agnes Blanche Delaney | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2005-05-27 |
| 1003466269 | Lukas Ward | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-09-18 |
| 1720632508 | Kaitlin Elizabeth Behnken | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-07-30 |
| 1356995401 | Cassandra Chambers | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-07-27 |
| 1992280598 | Corrie Lynn Farris | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2018-09-28 |
| 1497255947 | Kimberly Hankins | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2018-02-20 |
| 1689029993 | Ashley L. Brown | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2016-04-25 |
| 1669833026 | Jessica Milburn | Nurse Practitioner | 409 W Oak St, Carbondale, IL 62901-1464 | 2016-03-14 |
| 1093193773 | Andrea Williams | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1414 | 2015-05-13 |
| 1730578535 | Desiree Castonguay | Physician Assistant | 409 W Oak St, 202, Carbondale, IL 62901-1414 | 2015-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497255947 | Kimberly Hankins | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2018-02-20 |
| 1962731919 | Allison Campos | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2009-12-21 |
| 1063660074 | Nathaniel Clark | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2008-09-03 |
| 1063603520 | Magdalena Anna Zeglin | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1414 | 2007-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164984514 | Cil Care of Il II, LLC | Internal Medicine | 1900 E Golf Rd Ste 950, Schaumburg, IL 60173-5034 | 2019-04-04 |
| 1467950733 | Coordinated Health of Il, LLC | Internal Medicine | 1900 E Golf Rd Ste 950c, Schaumburg, IL 60173-5834 | 2018-01-31 |
| 1740728039 | Jenna Schrage | Internal Medicine | 317 N 5th St, Springfield, IL 62701-1003 | 2017-02-07 |
| 1417373010 | Hashim Gazi | Internal Medicine | 3331 West Deyoung, Suite 100, Marion, IL 62959 | 2014-03-07 |
| 1992041644 | Daniel Brent Nelson | Internal Medicine | 3810 Farhills Dr, Champaign, IL 61822-9321 | 2012-12-28 |
| 1801184767 | Surya Teja Chaturvedula | Internal Medicine | 5409 N Knoxville Ave Ste 207, Peoria, IL 61614-5069 | 2011-07-13 |
| 1841583952 | C Dean Katsamakis Do Facc Sc | Internal Medicine | 240 Waukegan Rd, Glenview, IL 60025-5159 | 2011-05-23 |
| 1154550119 | Elliott M Groves | Internal Medicine | 840 S Wood St Ste Smc715, Chicago, IL 60612-4325 | 2009-07-10 |
| 1841484813 | Elsayed Mohamed | Internal Medicine | 804 E Woodfield Rd Ste 300, Schaumburg, IL 60173-4776 | 2007-08-31 |
| 1952513335 | Muhammad Sikander Akbar | Internal Medicine | 6300 N Lincoln Ave, Chicago, IL 60659-1204 | 2007-05-05 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.