Individual
ISAM NASR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 W LAKE ST, MELROSE PARK, IL 60160-4039
(708) 681-3000
Mailing address
1449 W FLETCHER ST, #3, CHICAGO, IL 60657-2112
(773) 929-4728
(312) 864-9656
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036077687
IL
Other
Enumeration date
08/15/2005
Last updated
04/28/2021
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