Most Relevant Information
Provider Data
| NPI Number: | 1003815069 |
| Provider Name: | MAMDOUH H HASSABALLA M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 208D00000X |
| Specialty: | General Practice |
| License Number: | 036069096 |
Most Important Dates
| Enumeration Date: | 07/20/2005 |
| Last Updated: | 12/16/2015 |
Provider Practice Location
1105 MILWAUKEE AVE
RIVERWOODS
IL
600153512
Practice Location Phone/Fax
| Phone: | 8473255110 |
| Fax: | 8473255114 |
Provider Mailing Location
1105 MILWAUKEE AVE
RIVERWOODS
IL
600153512
Provider Mailing Phone/Fax
| Phone: | 8473255110 |
| Fax: | 8473255114 |