Individual
HANI RUSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(630) 890-3061
Mailing address
737 W WASHINGTON BLVD APT 2701, CHICAGO, IL 60661-2615
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036.166807
IL
Other
Enumeration date
03/25/2021
Last updated
12/18/2024
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