Provider Demographics
NPI:1255826699
Name:ISRAEL, NEHEMIAH-BEN
Entity Type:Individual
Prefix:
First Name:NEHEMIAH-BEN
Middle Name:
Last Name:ISRAEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 S HOXIE AVE UNIT REAR
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:IL
Mailing Address - Zip Code:60633-2125
Mailing Address - Country:US
Mailing Address - Phone:708-537-8806
Mailing Address - Fax:
Practice Address - Street 1:14100 S HOXIE AVE UNIT REAR
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:IL
Practice Address - Zip Code:60633-2125
Practice Address - Country:US
Practice Address - Phone:708-537-8806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist