Provider Demographics
NPI:1700440138
Name:SALMAN, JAWAD M
Entity Type:Individual
Prefix:
First Name:JAWAD
Middle Name:M
Last Name:SALMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16514 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1744
Mailing Address - Country:US
Mailing Address - Phone:708-945-2276
Mailing Address - Fax:
Practice Address - Street 1:39 BANKVIEW DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1861
Practice Address - Country:US
Practice Address - Phone:815-464-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-01
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor