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General NPI Number Information
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NPI Number | 1528582517
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Entity Type | Individual
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Provider Name | YOUSSEF JAMAL SHAMMAA M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2 GOOD SAMARITAN WAY
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City | MOUNT VERNON
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State | IL
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Zip | 62864-2408
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Country | US
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Telephone | 618-899-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 105 SPARTAN CIRCLE APT 1
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City | O FALLON
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State | IL
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Zip | 62269
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Country | US
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Telephone | 646-986-2940
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 308231-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 4301511751
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 036.175098
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036.175098
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License Number State | IL
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