Individual provider · NPI-1

Omar Mohammad Al-Heeti, MD

Internal Medicine, Infectious Disease · Decatur, IL

NPI number1083903645
StatusActive
Last updated in NPPESSep 25, 2024

Details

NPI
1083903645
Entity type
Individual (NPI-1)
Name
Omar Mohammad Al-Heeti
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 5, 2011
Certification date
Sep 25, 2024
Last updated
Sep 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RI0200X Internal Medicine, Infectious Disease036.133842ILYes
207R00000X Internal Medicine036133842IL

Practice location

304 W Hay St Ste 212
Decatur, IL 62526-6376

Phone 217-876-4390 · Fax 217-876-4395

Mailing address

304 W Hay St Ste 212
Decatur, IL 62526-6376

Phone 217-876-4390 · Fax 217-876-4395

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