Individual
MR. JAMAL MOSABBEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 344-5000
(815) 344-3347
Mailing address
4201 W MEDICAL CENTER DR, MCHENRY, IL 60050-8409
(815) 344-5000
(815) 344-3347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209016788
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214881
MEDICARE MULTISPECIALTY GROUP PTAN
IL
05
—
8051601
—
NC
01
—
P00603483
RAILROAD MEDICARE
NC
Enumeration date
07/18/2006
Last updated
12/01/2023
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