Provider Demographics
NPI:1932483930
Name:SABBAHI, AHMAD SAMIR (PT, MA, PHD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:SAMIR
Last Name:SABBAHI
Suffix:
Gender:M
Credentials:PT, MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10638 DANI LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2883
Mailing Address - Country:US
Mailing Address - Phone:347-471-5780
Mailing Address - Fax:
Practice Address - Street 1:10638 DANI LN
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2883
Practice Address - Country:US
Practice Address - Phone:347-471-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032679225100000X
IL070.019937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist