Healthcare Provider Details

I. General information

NPI: 1649410382
Provider Name (Legal Business Name): HUSSEIN MOHAMAD SAID KANDIL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W. TAYLOR
CHICAGO IL
60612
US

IV. Provider business mailing address

820 S. WOOD ST. NC 675 SUITE 100 UIC GRADUATE MEDICAL EDUCATION
CHICAGO IL
60612-7311
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125.055587
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: