Provider Demographics
NPI:1568148989
Name:AL ZOUBI, SARAH MOH'D AL SHAFI MOH'D (MD)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MOH'D AL SHAFI MOH'D
Last Name:AL ZOUBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:GME. 820 S. WOODS STREET
Mailing Address - Street 2:SUITE 100, MC 675
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-2933
Mailing Address - Fax:312-996-3050
Practice Address - Street 1:GME. 820 S. WOODS STREET
Practice Address - Street 2:SUITE 100, MC 675
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-2933
Practice Address - Fax:312-996-3050
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
IL125082973246ZN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZN0300XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program