Provider Demographics
NPI:1174552228
Name:NAOUR, DAVID H (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:H
Last Name:NAOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1300 FRANKLIN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3588
Mailing Address - Country:US
Mailing Address - Phone:309-268-3900
Mailing Address - Fax:309-268-3910
Practice Address - Street 1:1300 FRANKLIN AVE STE 210
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3588
Practice Address - Country:US
Practice Address - Phone:309-268-3900
Practice Address - Fax:309-268-3910
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095383208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095383OtherPUBLIC AID
IL05720147OtherBLUE CROSS BLUE SHIELD
833120OtherMEDICARE GROUP #
833120020Medicare PIN
IL036095383OtherPUBLIC AID
IL299640Medicare PIN