Healthcare Provider Details

I. General information

NPI: 1619292968
Provider Name (Legal Business Name): CAMELIA ANTOINETTE MUSLEH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 GROSS POINT RD STE 3900
SKOKIE IL
60076-5085
US

IV. Provider business mailing address

9650 GROSS POINT RD STE 3900
SKOKIE IL
60076-5085
US

V. Phone/Fax

Practice location:
  • Phone: 847-663-8200
  • Fax: 847-570-2984
Mailing address:
  • Phone: 847-663-8200
  • Fax: 847-570-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036135178
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number036135178
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: