Healthcare Provider Details

I. General information

NPI: 1326280264
Provider Name (Legal Business Name): RANIA HAFETH SALEH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SILVER CROSS BLVD STE 320
NEW LENOX IL
60451-9610
US

IV. Provider business mailing address

PO BOX 9450
NAPERVILLE IL
60567-0450
US

V. Phone/Fax

Practice location:
  • Phone: 331-260-9010
  • Fax: 331-866-3002
Mailing address:
  • Phone: 331-260-9010
  • Fax: 331-866-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.130253
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036130253
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number53717
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number271
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036.130253
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: