Individual
MOHAMAD JALAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
19015 S JODI RD STE H, MOKENA, IL 60448-8534
(708) 995-5418
Mailing address
19015 S JODI RD STE H, MOKENA, IL 60448-8534
(708) 995-5418
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238000603
ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION
IL
Enumeration date
03/02/2022
Last updated
03/02/2022
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