Individual
AYYAH SAMIR GHOULEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6415 W 84TH ST, BURBANK, IL 60459-2412
(708) 595-2636
Mailing address
6415 W 84TH ST, BURBANK, IL 60459-2412
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.029010
IL
Other
Enumeration date
12/25/2023
Last updated
12/25/2023
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