Provider Demographics
NPI:1558575050
Name:ELSHAMY, ALAA (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALAA
Middle Name:
Last Name:ELSHAMY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7238 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1709
Mailing Address - Country:US
Mailing Address - Phone:708-691-6191
Mailing Address - Fax:708-599-0970
Practice Address - Street 1:7238 W 85TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-1709
Practice Address - Country:US
Practice Address - Phone:708-691-6191
Practice Address - Fax:708-599-0970
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist