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Individual

DR. JALAL DAHSHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4817 W 83RD ST, BURBANK, IL 60459-2790
(708) 425-3135
(708) 425-6884
Mailing address
12082 BLACKTHORNE RIDGE DR, MOKENA, IL 60448-8118
(773) 459-8227
(708) 581-3936

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088926
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01608243
BLUE CROSS
IL
01
01639156
BLUE CROSS
IL
05
036088926
IL
Enumeration date
07/06/2006
Last updated
04/12/2017
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