Provider Demographics
NPI:1447578232
Name:YOUSSIEF, ASHRAF
Entity Type:Individual
Prefix:MR
First Name:ASHRAF
Middle Name:
Last Name:YOUSSIEF
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 1:12413 S HARLEM AVE
Mailing Address - Street 2:SUITE # 1.S E
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1442
Mailing Address - Country:US
Mailing Address - Phone:708-361-1133
Mailing Address - Fax:708-361-1188
Practice Address - Street 1:12413 S HARLEM AVE
Practice Address - Street 2:SUITE # 1.S E
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1442
Practice Address - Country:US
Practice Address - Phone:708-361-1133
Practice Address - Fax:708-361-1188
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007546225100000X
IL070.007546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist