Individual
HANI AHMAD GHANDOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
836 W WELLINGTON AVE APT 1908, CHICAGO, IL 60657-5147
(773) 829-7443
Mailing address
856 W NELSON ST APT 1908, CHICAGO, IL 60657-9202
(773) 829-7443
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.075287
IL
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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