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General NPI Number Information
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NPI Number | 1740344241
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Entity Type | Individual
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Provider Name | NABIL MOHAMED ISSA MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/17/2012
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Provider Practice Location Address
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Address Line | 676 N SAINT CLAIR ST SUITE 650
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City | CHICAGO
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State | IL
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Zip | 60611-2927
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Country | US
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Telephone | 312-695-4835
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Fax | 312-695-3644
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Provider Business Mailing Address
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Address Line | 676 N SAINT CLAIR ST SUITE 650
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City | CHICAGO
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State | IL
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Zip | 60611-2927
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Country | US
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Telephone | 312-695-4835
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Fax | 312-695-3644
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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 | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 35083861
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 036119396
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 036119396
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 4301088782
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License Number State | MI
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