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Organization

BURBANK MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JALAL DAHSHE MD (PROVIDER)
(708) 425-3135
Entity
Organization

Contact information

Practice address
4817 W 83RD ST, BURBANK, IL 60429
(708) 425-3135
(708) 425-6884
Mailing address
9229 MASSASOIT AVE, OAK LAWN, IL 60453
(708) 422-2023
(708) 423-2991

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088926
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
030088926
IL
Enumeration date
03/08/2013
Last updated
03/08/2013
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