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Individual

JIHAD KUDSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 PENNSYLVANIA AVE STE 350, GLEN ELLYN, IL 60137-4464
(630) 790-1700
(630) 545-7531
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036145913
IL
208600000X
Surgery Physician
R0892
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
368074601
TX
01
8GL598
BLUE CROSS BLUE SHIELD
TX
Enumeration date
10/20/2009
Last updated
08/09/2023
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