Provider Demographics
NPI:1639235955
Name:ELDAHDAH, LAMA THERESE
Entity Type:Individual
Prefix:
First Name:LAMA
Middle Name:THERESE
Last Name:ELDAHDAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 N HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5105
Mailing Address - Country:US
Mailing Address - Phone:773-472-4900
Mailing Address - Fax:
Practice Address - Street 1:2825 N HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5105
Practice Address - Country:US
Practice Address - Phone:773-472-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS