MEDICARE: ALA'A MASHAL FNP

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	363LF0000X	Family Nurse Practitioner	209.031654	IL

General Provider Information

NPI Number	:	1407651854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALA'A MASHAL FNP

Provider Business Mailing Address
First Line	:	15290 EL CAMENO TER APT 1E
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-3690
Country	:	US
Telephone Number	:	704-488-8280
Fax Number	:

Provider Business Practice Location Address
First Line	:	9505 142ND ST STE 23
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-4293
Country	:	US
Telephone Number	:	704-488-8280
Fax Number	:

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

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	02/04/2026

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