Provider Demographics
NPI:1598370090
Name:SALEH, TAREK SAID (PT)
Entity Type:Individual
Prefix:
First Name:TAREK
Middle Name:SAID
Last Name:SALEH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2778
Mailing Address - Country:US
Mailing Address - Phone:708-952-1052
Mailing Address - Fax:
Practice Address - Street 1:9030 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4303
Practice Address - Country:US
Practice Address - Phone:773-721-5656
Practice Address - Fax:773-721-5757
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.020509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist