Healthcare Provider Details

I. General information

NPI: 1376299065
Provider Name (Legal Business Name): HAMDARD HEALTH ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4157 MAIN ST
SKOKIE IL
60076-2780
US

IV. Provider business mailing address

228 E LAKE ST
ADDISON IL
60101-2889
US

V. Phone/Fax

Practice location:
  • Phone: 773-465-4600
  • Fax: 773-465-4666
Mailing address:
  • Phone: 630-835-1430
  • Fax: 630-835-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAWN BAILEY
Title or Position: FINANCE ADMINISTRATION MANAGER
Credential:
Phone: 630-835-1430