Individual
MAHMOUD ABUSAOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6930 S PULASKI RD, CHICAGO, IL 60629-4223
(773) 312-5178
Mailing address
9338 PEPPERWOOD DR, ORLAND HILLS, IL 60487-5604
(708) 407-1309
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019032237
IL
Other
Enumeration date
07/09/2019
Last updated
07/09/2019
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