MEDICARE: GHASSAN D ASWAD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	036091245	IL
2	208000000X	Pediatrics Physician	036091245	IL

General Provider Information

NPI Number	:	1013954486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GHASSAN D ASWAD MD

Provider Business Mailing Address
First Line	:	3754 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3116
Country	:	US
Telephone Number	:	773-509-1467
Fax Number	:

Provider Business Practice Location Address
First Line	:	3754 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3116
Country	:	US
Telephone Number	:	773-509-0600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	04/21/2021

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Directions to “ GHASSAN D ASWAD MD” Practice Location

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