Provider Demographics
NPI:1104597830
Name:KANDIL, KAREEM (MD, ND)
Entity type:Individual
Prefix:
First Name:KAREEM
Middle Name:
Last Name:KANDIL
Suffix:
Gender:M
Credentials:MD, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 HERMITAGE TRL UNIT 6
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-7002
Mailing Address - Country:US
Mailing Address - Phone:815-605-5595
Mailing Address - Fax:
Practice Address - Street 1:633 E 21ST AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2323
Practice Address - Country:US
Practice Address - Phone:815-605-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61137140175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty