Provider Demographics
NPI:1053867523
Name:MOHAMED, REEM
Entity Type:Individual
Prefix:
First Name:REEM
Middle Name:
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REEM
Other - Middle Name:HAFEZ
Other - Last Name:EL-RAMAHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14145 JOHN HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2073
Mailing Address - Country:US
Mailing Address - Phone:708-310-5115
Mailing Address - Fax:
Practice Address - Street 1:16335 HARLEM AVE
Practice Address - Street 2:SUITE 424
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2574
Practice Address - Country:US
Practice Address - Phone:708-310-5115
Practice Address - Fax:708-294-3993
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional