DR. REFAT DAHERDIAB KHADER (NPI# 1073505988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073505988 |
| Entity Type | Individual |
| Full Name | DR. REFAT DAHERDIAB KHADER |
| Credential | M.D. |
| Practice Address |
405 W Jackson St Carbondale IL 62901-1462 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185490721 |
| Practice Fax Number | 6185290449 |
| Mailing Telephone | 6184575200 |
| Mailing Fax Number | 6185290586 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 036099655 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NGS GROUP PTAN | 214881 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 S 14th St, Herrin, IL 629483631 | 6189422171 | 6183514919 |
| 2 S Hospital Dr, Murphysboro, IL 629663333 | 6186843165 | 6185290529 |
| 510 Lincoln Dr, Herrin, IL 629486334 | 6189976800 | 6189938188 |
| Street Address |
405 W JACKSON ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194726851 | Shahriar Bozorgzadeh | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-03 |
| 1568071132 | Cynthia Sue Davis | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-29 |
| 1629686019 | Dianne Zuasula Catolos | Physical Therapist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-21 |
| 1871113696 | Summer R Black | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-04-22 |
| 1871123067 | Hailee Elizabeth Bowlin | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-01-16 |
| 1972061737 | Briana Nichole Jones | Speech-Language Pathologist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2019-03-11 |
| 1700362183 | John Grady Johnston Jr. | Registered Nurse | 405 W Jackson St, Carbondale, IL 62901 | 2018-07-18 |
| 1972099067 | Andrew Mcnally | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-07-02 |
| 1134610587 | Megan E Sims | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-22 |
| 1447749833 | Erika Diericx | Pharmacist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407858806 | Jeffrey Lee Frakes | Anesthesiology | 405 W Jackson Street, Sih Medical Group Anesthesiology, Carbondale, IL 62901 | 2005-08-15 |
| 1255333118 | Jai P. Singh | Anesthesiology | 35 Albany Rd, Suite C, Carbondale, IL 62903-7605 | 2005-08-11 |
| 1659751998 | Allison Magnuson | Anesthesiology | 405 W Jackson St, Carbondale, IL 62901-1462 | 2015-06-02 |
| 1265852644 | Purnima Sharma | Anesthesiology | 405 W Jackson Street, Dba Sih Medical Group Anesthesiology, Carbondale, IL 62901 | 2014-04-23 |
| 1225470602 | Michael Stanley | Anesthesiology | 405 W Jackson Street, Dba Sih Medical Group Anesthesiology, Carbondale, IL 62901 | 2013-07-25 |
| 1649618620 | Qianqian Xu | Anesthesiology | 405 W Jackson St, Carbondale, IL 62901-1462 | 2013-06-12 |
| 1811240187 | Vikram S Bajwa | Anesthesiology | 405 W Jackson Street, Sih Medical Group Anesthesiology, Carbondale, IL 62901 | 2012-10-23 |
| 1134414618 | Ryan Stock | Anesthesiology | 35 Albany Rd, Suite C, Carbondale, IL 62903-7646 | 2011-06-13 |
| 1013112283 | Long Ha Huynh | Anesthesiology | 405 W Jackson St, Carbondale, IL 62901-1462 | 2007-06-18 |
| 1679775647 | Aileen Marie Galan | Anesthesiology | 405 W Jackson St, Carbondale, IL 62901-1462 | 2007-06-01 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.