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General NPI Number Information
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NPI Number | 1790928893
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Entity Type | Organization
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Legal Business Name | ALPHA MED PHYSICIANS GROUP, LLC
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 17901 GOVERNORS HWY SUITE 106
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-957-2100
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Fax | 708-957-8044
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Provider Business Mailing Address
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Address Line | 17901 GOVERNORS HWY SUITE 106
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-957-2100
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Fax | 708-957-8044
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Authorized Official
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Title or Position | MANAGER
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Name | M . MUFFADDAL HAMADEH
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Credential | M.D.
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Telephone | 708-957-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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