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General NPI Number Information
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NPI Number | 1588140552
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Entity Type | Individual
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Provider Name | AMJAD ELMASHALA MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1620 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3801
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Country | US
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Telephone | 319-471-5605
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Fax |
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Provider Business Mailing Address
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Address Line | 221 W HARRISON ST APT 412
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City | CHICAGO
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State | IL
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Zip | 60607-5049
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Country | US
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Telephone | 319-471-5605
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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 | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 036175150
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License Number State | IL
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