Individual
IMAD DABABNEH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4150 WILLIAMSBURG CT. APT 101, GLENVIEW, IL 60025
(708) 770-6005
Mailing address
4150 WILLIAMSBURG CT APT 101, GLENVIEW, IL 60025-3886
(708) 770-6005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011072
IL
152W00000X
Optometrist
2185D
OR
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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