Provider Demographics
NPI:1679549299
Name:HATOUM, NAWAR (MD)
Entity Type:Individual
Prefix:
First Name:NAWAR
Middle Name:
Last Name:HATOUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 N HALSTED ST
Mailing Address - Street 2:CHICAGO MATERNAL FETAL MEDICINE, S.C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-9267
Mailing Address - Country:US
Mailing Address - Phone:773-348-8032
Mailing Address - Fax:773-348-8042
Practice Address - Street 1:2507 N HALSTED ST
Practice Address - Street 2:CHICAGO MATERNAL FETAL MEDICINE, S.C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-9267
Practice Address - Country:US
Practice Address - Phone:773-348-8032
Practice Address - Fax:773-348-8042
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-085930207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085930Medicaid
IL1633117OtherBC&BS
ILE86929Medicare UPIN