Healthcare Provider Details

I. General information

NPI: 1184363012
Provider Name (Legal Business Name): DR. RAGHAD AL-AUBID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16888 BASELINE AVE
FONTANA CA
92336-2083
US

IV. Provider business mailing address

1044 N FRANCISCO AVE
CHICAGO IL
60622-2743
US

V. Phone/Fax

Practice location:
  • Phone: 855-422-8029
  • Fax:
Mailing address:
  • Phone: 773-292-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA202011
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125.079310
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: