Provider Demographics
NPI:1265783211
Name:DAWUD, NADINE M
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:M
Last Name:DAWUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6526 DEER LN
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2272
Mailing Address - Country:US
Mailing Address - Phone:708-717-9563
Mailing Address - Fax:
Practice Address - Street 1:4677 N VIRGINIA AVE
Practice Address - Street 2:1N
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2953
Practice Address - Country:US
Practice Address - Phone:312-520-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-29
Last Update Date:2012-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst