Provider Demographics
NPI:1629511068
Name:DAWUD, ADWAA (NP)
Entity Type:Individual
Prefix:
First Name:ADWAA
Middle Name:
Last Name:DAWUD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 W 167TH ST
Mailing Address - Street 2:
Mailing Address - City:TINELY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-5026
Mailing Address - Country:US
Mailing Address - Phone:708-429-3700
Mailing Address - Fax:
Practice Address - Street 1:6700 167TH ST
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2859
Practice Address - Country:US
Practice Address - Phone:708-429-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015202363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily