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General NPI Number Information
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NPI Number | 1396284717
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Entity Type | Individual
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Provider Name | SALEH HATOUM MD
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Gender | Male
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 09/25/2020
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Provider Practice Location Address
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Address Line | 327 IL ROUTE 2
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City | DIXON
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State | IL
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Zip | 61021-9118
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Country | US
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Telephone | 815-284-1111
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Fax | 815-284-2306
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Provider Business Mailing Address
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Address Line | 4278 N HAZEL ST APT 4F
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City | CHICAGO
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State | IL
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Zip | 60613-1673
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Country | US
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Telephone | 847-912-8056
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 036.150052
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License Number State | IL
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