Provider Demographics
NPI:1174522866
Name:KAMEL, PERRY L (MD)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:L
Last Name:KAMEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 N MAUD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4908
Mailing Address - Country:US
Mailing Address - Phone:312-573-9626
Mailing Address - Fax:312-573-9636
Practice Address - Street 1:1944 N MAUD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4908
Practice Address - Country:US
Practice Address - Phone:312-573-9626
Practice Address - Fax:312-573-9636
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2024-06-20
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
IL036068967207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036068967Medicare ID - Type Unspecified
ILD16679Medicare UPIN
IL398880Medicare ID - Type Unspecified