Provider Demographics
NPI:1760987812
Name:HAMOUD, HANAA (CNA)
Entity Type:Individual
Prefix:
First Name:HANAA
Middle Name:
Last Name:HAMOUD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17045 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3666
Mailing Address - Country:US
Mailing Address - Phone:708-829-3458
Mailing Address - Fax:
Practice Address - Street 1:19849 GREEN MEADOWS PKWY
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-3306
Practice Address - Country:US
Practice Address - Phone:708-829-3458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide