Provider Demographics
NPI:1477561553
Name:SALEM, ATIYEH (DPM)
Entity Type:Individual
Prefix:DR
First Name:ATIYEH
Middle Name:
Last Name:SALEM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 W COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1145
Mailing Address - Country:US
Mailing Address - Phone:708-448-9300
Mailing Address - Fax:708-448-9380
Practice Address - Street 1:7226 W COLLEGE DR
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1145
Practice Address - Country:US
Practice Address - Phone:708-845-6565
Practice Address - Fax:708-448-9380
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016033399213ES0103X
IL016003399213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery