MEDICARE: SALAM ALTIBI

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1871485318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALAM ALTIBI

Provider Business Mailing Address
First Line	:	1209 W GLENN LN
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 W GLENN LN
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4014
Country	:	US
Telephone Number	:	312-934-4161
Fax Number	:

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

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	07/18/2025

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Directions to “ SALAM ALTIBI ” Practice Location

Language	Start Address	Practice Location

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