Individual
MUTASEM MOUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
9830 RIDGELAND AVE STE 9A, CHICAGO RIDGE, IL 60415-2668
(708) 642-6457
Mailing address
9830 RIDGELAND AVE, CHICAGO RIDGE, IL 60415-2667
(708) 642-6457
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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