Provider Demographics
NPI:1902860083
Name:HAMADEH, MUHAMMAD ABDULGANY (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ABDULGANY
Last Name:HAMADEH
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 1:10604 SOUTHWEST HIGHWAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-2717
Mailing Address - Country:US
Mailing Address - Phone:708-371-8006
Mailing Address - Fax:708-389-6630
Practice Address - Street 1:10604 SOUTHWEST HIGHWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2717
Practice Address - Country:US
Practice Address - Phone:708-371-8006
Practice Address - Fax:708-389-6630
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075504207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632457OtherBLUE CROSS BLUE SHIELD
ILP00134249OtherRAILROAD MEDICARE
IL036075504Medicaid
ILE82475Medicare UPIN
IL036075504Medicaid