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General NPI Number Information
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NPI Number | 1538139316
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Entity Type | Individual
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Provider Name | MOHAMED MEDHAT SALEM M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 331 W SURF ST STE 703
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City | CHICAGO
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State | IL
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Zip | 60657-7227
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Country | US
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Telephone | 773-525-4701
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Fax | 773-326-3539
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Provider Business Mailing Address
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Address Line | 2845 N SHERIDAN RD STE 703
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-525-4701
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Fax | 773-326-3539
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 036072417
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License Number State | IL
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