MEDICARE: JIHAD ALHARASH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	304237	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207R00000X	Internal Medicine Physician	036.152557	IL

General Provider Information

NPI Number	:	1598119216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIHAD ALHARASH M.D.

Provider Business Mailing Address
First Line	:	9S525 ALLISON CT
Second Line	:
City	:	WILLOWBROOK
State	:	IL
Zip	:	60527-7041
Country	:	US
Telephone Number	:	773-747-1039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 W POLK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3723
Country	:	US
Telephone Number	:	312-864-4522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	11/22/2021

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