Provider Demographics
NPI:1164548848
Name:RAMADAN, FATMA ELZHRA HOSSINI (MD)
Entity Type:Individual
Prefix:DR
First Name:FATMA
Middle Name:ELZHRA HOSSINI
Last Name:RAMADAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1748
Mailing Address - Country:US
Mailing Address - Phone:708-756-1000
Mailing Address - Fax:708-709-6353
Practice Address - Street 1:333 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1748
Practice Address - Country:US
Practice Address - Phone:708-756-1000
Practice Address - Fax:708-709-6353
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069803A208M00000X
IL036112579207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203979001OtherPTAN
IL036112579/PAYEECODE2Medicaid
IL05-0540914OtherTAX-ID
ILP00691224OtherRAIL ROAD PTAN
IL05-0540914OtherTAX-ID