| Doctor Name: | NIDAL ALKAFARNA |
| NPI Number: | 1053796136 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 085005577 |
| Business Practice Address: | 200 S Greenleaf St Ste A Gurnee, IL - 600313398 |
| Business Phone Number: | 8472446060 |
| Business Fax Number: | |
| Mailing Address: | 2650 Warrenville Rd, Suite 280 DOWNERS GROVE |
| State: | IL |
| Postal Code: | 605151748 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2015 |
| NPI Last Update Date: | 07/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 085005577 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |