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General NPI Number Information
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NPI Number | 1093670416
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Entity Type | Individual
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Provider Name | SHARAFELDIN MOHAMMED SA-C
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Gender | Male
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 8133 VALLEY DR
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City | PALOS HILLS
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State | IL
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Zip | 60465-2239
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Country | US
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Telephone | 872-210-7324
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Fax | 708-398-8800
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Provider Business Mailing Address
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Address Line | 8133 VALLEY DR
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City | PALOS HILLS
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State | IL
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Zip | 60465-2239
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Country | US
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Telephone | 872-210-7324
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Fax | 708-398-8800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 23800489
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License Number State | IL
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