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NPI Code Detail

MEDICARE: SAKER GHANAYEM

MEDICARE: SAKER GHANAYEM
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
1225100000XPhysical Therapist070026291IL
2225100000XPhysical TherapistME

General Provider Information

NPI Number : 1245858638
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAKER GHANAYEM
Provider Business Mailing Address
First Line : 955 W FOSTER AVE APT 111
Second Line :
City : CHICAGO
State : IL
Zip : 60640-2536
Country : US
Telephone Number : 207-404-0106
Fax Number :
Provider Business Practice Location Address
First Line : 1214 W. LOYOLA CT
Second Line :
City : CHICAGO
State : IL
Zip : 60626-5102
Country : US
Telephone Number : 773-274-1769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2020
Last Update Date : 10/06/2021

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Directions to “ SAKER GHANAYEM ” Practice Location

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