Individual
ALEXANDER GHANAYEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, SUITE 1700, MAYWOOD, IL 60153-3328
(708) 216-3280
(708) 216-6223
Mailing address
2160 S 1ST AVE, SUITE 1700, MAYWOOD, IL 60153-3328
(708) 216-3280
(708) 216-6223
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
36090804
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36090804
—
IL
Enumeration date
02/14/2006
Last updated
06/03/2011
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