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General NPI Number Information
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NPI Number | 1205998481
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Entity Type | Organization
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Legal Business Name | ALL CARE FAMILY MEDICAL INC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 4753 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-4002
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Country | US
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Telephone | 773-427-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 4753 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-4002
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Country | US
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Telephone | 773-427-4900
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MOHAMED OMAR ALSAMMAN
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Credential |
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Telephone | 773-715-3269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036091379
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License Number State | IL
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