Provider Demographics
NPI:1427205400
Name:HAMAD, DENA ZAHIR (MD)
Entity Type:Individual
Prefix:DR
First Name:DENA
Middle Name:ZAHIR
Last Name:HAMAD
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 1:7900 W LAWRENCE AVE
Mailing Address - Street 2:UNIT D
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-3296
Mailing Address - Country:US
Mailing Address - Phone:312-560-5438
Mailing Address - Fax:
Practice Address - Street 1:4900 N CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2916
Practice Address - Country:US
Practice Address - Phone:708-456-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036123156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036123156Medicaid
IL616040039Medicare PIN