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General NPI Number Information
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NPI Number | 1104300565
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Entity Type | Individual
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Provider Name | HIBA HAMMADI
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Gender | Female
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 19056 HENRY DR
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City | MOKENA
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State | IL
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Zip | 60448-9302
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Country | US
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Telephone | 708-995-5751
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Fax |
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Provider Business Mailing Address
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Address Line | 6508 FIRESIDE DR
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City | CHICAGO RIDGE
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State | IL
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Zip | 60415-1310
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Country | US
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Telephone | 708-898-8289
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.01396
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License Number State | IL
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