MEDICARE: MR. HISHAM SAAD SADEK 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	2084P0800X	Psychiatry Physician		IL

General Provider Information

NPI Number	:	1619941614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HISHAM SAAD SADEK MD

Provider Business Mailing Address
First Line	:	683 KATHERYNE LANE
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101
Country	:	US
Telephone Number	:	630-629-9108
Fax Number	:	630-629-3597

Provider Business Practice Location Address
First Line	:	2004 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639
Country	:	US
Telephone Number	:	773-772-8876
Fax Number	:	708-444-1124

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	04/02/2008

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