Organization
BURBANK MEDICAL CENTER SC
Active
Organization
BURBANK MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JALAL DAHSHE MD (PRESIDENT)
(708) 425-3135
Entity
Organization
Contact information
Practice address
4817 W 83RD ST, BURBANK, IL 60459-2790
(708) 425-3135
(708) 425-6884
Mailing address
4817 W 83RD ST, BURBANK, IL 60459-2790
(708) 425-3135
(708) 425-6884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088926
IL
207V00000X
Obstetrics & Gynecology Physician
036054337
IL
213E00000X
Podiatrist
016002638
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01639156
BLUE CROSS
IL
05
—
036088926
—
IL
Enumeration date
03/28/2008
Last updated
07/10/2008
Update your record
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