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Individual

MR. IBRAHIM ALDASOQI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
606 POTTER RD, DES PLAINES, IL 60016-5337
(773) 319-2317
Mailing address
1304 RICHMOND AVE, WESTMONT, IL 60559-3373
(773) 319-2317

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209010319
IL

Other

Enumeration date
11/07/2013
Last updated
11/07/2013
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