Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 036134460 | IL |
NPI | 1033427794 |
---|---|
Provider Name | Dr. Mohamad Adel Abdessamad |
First Address | Chicago, IL 60674 |
Second Address | Tinley Park, IL 60487-7581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 27/06/2017 |