MEDICARE: LAURA ADEL SAMY RAHEB 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	207R00000X	Internal Medicine Physician	125.072850	IL

General Provider Information

NPI Number	:	1417440942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA ADEL SAMY RAHEB MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE # 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-982-3175
Fax Number	:	847-982-3394

Provider Business Practice Location Address
First Line	:	2205 BUTTERFIELD RD
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1157
Country	:	US
Telephone Number	:	331-221-9001
Fax Number	:	331-221-3971

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

Provider Enumeration Date	:	06/09/2018
Last Update Date	:	10/20/2025

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