Provider Demographics
NPI:1417381963
Name:KAMEL, LAMYA (LAC)
Entity Type:Individual
Prefix:
First Name:LAMYA
Middle Name:
Last Name:KAMEL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 W DIVERSEY PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1682
Mailing Address - Country:US
Mailing Address - Phone:773-270-3714
Mailing Address - Fax:
Practice Address - Street 1:561 W DIVERSEY PKWY STE 208
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1682
Practice Address - Country:US
Practice Address - Phone:773-270-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001082171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist