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General NPI Number Information
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NPI Number | 1811668809
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Entity Type | Organization
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Legal Business Name | KIDDOS URGENT CARE PLLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 3 YORKTOWN SHOPPING CTR
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City | LOMBARD
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State | IL
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Zip | 60148-5516
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Country | US
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Telephone | 316-737-3602
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 MIDWEST CLUB PKWY
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City | OAK BROOK
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State | IL
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Zip | 60523-2524
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Country | US
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Telephone | 316-737-3602
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMAD AL-AHDAB
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Credential | MD
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Telephone | 316-737-3602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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