Provider Demographics
NPI:1720557010
Name:ALASASLEH, ABLA ABDOLAH (MASTER)
Entity Type:Individual
Prefix:
First Name:ABLA
Middle Name:ABDOLAH
Last Name:ALASASLEH
Suffix:
Gender:F
Credentials:MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9745 S 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3050
Mailing Address - Country:US
Mailing Address - Phone:708-506-0390
Mailing Address - Fax:
Practice Address - Street 1:8119 W 84TH ST APT 2W
Practice Address - Street 2:
Practice Address - City:JUSTICE
Practice Address - State:IL
Practice Address - Zip Code:60458-2226
Practice Address - Country:US
Practice Address - Phone:708-506-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist