MEDICARE: HOSSAM MOHAMED

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	225100000X	Physical Therapist	070007491	IL

General Provider Information

NPI Number	:	1841364080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOSSAM MOHAMED

Provider Business Mailing Address
First Line	:	205 E BUTTERFIELD RD STE 154
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-5103
Country	:	US
Telephone Number	:	630-800-3626
Fax Number	:	630-261-0716

Provider Business Practice Location Address
First Line	:	951 OAK ST
Second Line	:
City	:	NORTH AURORA
State	:	IL
Zip	:	60542-1579
Country	:	US
Telephone Number	:	630-800-3626
Fax Number	:	630-261-0716

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	01/30/2019

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Directions to “ HOSSAM MOHAMED ” Practice Location

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