Provider Demographics
NPI:1710265483
Name:DAWOOD, SHERIF FAHMY TAWADROS
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:FAHMY TAWADROS
Last Name:DAWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101E N SHERIDAN RD UNIT 37B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-6825
Mailing Address - Country:US
Mailing Address - Phone:714-944-8253
Mailing Address - Fax:
Practice Address - Street 1:5683 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6220
Practice Address - Country:US
Practice Address - Phone:773-274-1447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-132575207W00000X
IL036.132575207WX0120X
IL125057337207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty