Provider Demographics
NPI:1356063143
Name:HAMADEH, DANA
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HAMADEH
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 1:9343 S THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-2163
Mailing Address - Country:US
Mailing Address - Phone:937-815-3244
Mailing Address - Fax:
Practice Address - Street 1:1935 SPRINGBROOK SQUARE DR STE 109
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5948
Practice Address - Country:US
Practice Address - Phone:937-815-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician