Healthcare Provider Details

I. General information

NPI: 1700476009
Provider Name (Legal Business Name): NABIL SALEH MD, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 W LAKE ST STE D
MELROSE PARK IL
60160-3930
US

IV. Provider business mailing address

1419 W LAKE ST STE D
MELROSE PARK IL
60160-3930
US

V. Phone/Fax

Practice location:
  • Phone: 708-450-0112
  • Fax: 708-450-9038
Mailing address:
  • Phone: 708-450-0112
  • Fax: 708-450-9038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NABIL SALEH
Title or Position: PRESIDENT,NABIL SALEH MD LTD
Credential: MD
Phone: 708-450-0112