Provider Demographics
NPI:1821033606
Name:AKRAM RAZZOUK MD SC
Entity Type:Organization
Organization Name:AKRAM RAZZOUK MD SC
Other - Org Name:SALT CREEK THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZZOUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-850-2120
Mailing Address - Street 1:999 OAKMONT PLAZA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-1381
Mailing Address - Country:US
Mailing Address - Phone:630-850-2120
Mailing Address - Fax:630-850-2123
Practice Address - Street 1:999 OAKMONT PLAZA DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1381
Practice Address - Country:US
Practice Address - Phone:630-850-2120
Practice Address - Fax:630-850-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336029146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty