Individual
IBRAHIM ASSEIDAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1855 W TAYLOR ST, CHICAGO, IL 60612-7242
(312) 996-7445
Mailing address
1631 S MICHIGAN AVE, APT 302, VILLA PARK, IL 60181-4101
(313) 231-5210
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301087384
MI
Other
Enumeration date
04/06/2007
Last updated
07/30/2007
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