MEDICARE: ALL CARE FAMILY MEDICAL INC

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	207R00000X	Internal Medicine Physician	036091379	IL

General Provider Information

NPI Number	:	1205998481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL CARE FAMILY MEDICAL INC

Provider Business Mailing Address
First Line	:	4753 N ELSTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4002
Country	:	US
Telephone Number	:	773-427-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	4753 N ELSTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4002
Country	:	US
Telephone Number	:	773-427-4900
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	MOHAMED OMAR ALSAMMAN
Credential	:
Telephone Number	:	773-715-3269

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	06/13/2008

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