Provider Demographics
NPI:1184878936
Name:RHONDA I KHOURI,D.D.S/P.S
Entity type:Organization
Organization Name:RHONDA I KHOURI,D.D.S/P.S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:KHOURI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-233-6512
Mailing Address - Street 1:7257 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1821
Mailing Address - Country:US
Mailing Address - Phone:708-233-6512
Mailing Address - Fax:
Practice Address - Street 1:7257 W. 87TH STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455
Practice Address - Country:US
Practice Address - Phone:708-233-6512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0242181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty