Provider Demographics
NPI:1740344241
Name:ISSA, NABIL MOHAMED (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:MOHAMED
Last Name:ISSA
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 1:676 N SAINT CLAIR ST
Mailing Address - Street 2:SUITE 650
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2927
Mailing Address - Country:US
Mailing Address - Phone:312-695-4835
Mailing Address - Fax:312-695-3644
Practice Address - Street 1:676 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 650
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2927
Practice Address - Country:US
Practice Address - Phone:312-695-4835
Practice Address - Fax:312-695-3644
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350838612086S0127X
IL0361193962086S0102X, 2086S0127X
MI43010887822086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care