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3 Yorktown Shopping Ctr Lombard IL 60148-5516 | |
| (630) 520-5990 | |
| (630) 323-9044 |
| Full Name | |
|---|---|
| Speciality | Pediatrics - Pediatric Cardiology |
| Location | 3 Yorktown Shopping Ctr, Lombard, Illinois |
| Authorized Official Name and Position | Mohamad Khaled Al-ahdab (PRESIDENT) |
| Authorized Official Contact | 3164408800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3 Yorktown Shopping Ctr Lombard IL 60148-5516 Ph: (630) 520-5990 | 3 Yorktown Shopping Ctr Lombard IL 60148-5516 Ph: (630) 520-5990 |
| NPI Number | 1558759738 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 01/01/2025 |
| Certification Date | 01/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558759738 | NPI | - | NPPES |
| 036105004 | Medicaid | IL | |
| 200096860A | Medicaid | OK | |
| 201276620A | Medicaid | IN | |
| 200414260C | Medicaid | KS |
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