Provider Demographics
NPI:1831170539
Name:ASAAD, SALWA F (MD)
Entity type:Individual
Prefix:DR
First Name:SALWA
Middle Name:F
Last Name:ASAAD
Suffix:
Gender:F
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:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0379
Mailing Address - Country:US
Mailing Address - Phone:708-460-9836
Mailing Address - Fax:708-460-1117
Practice Address - Street 1:1301 COPPERFIELD AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2054
Practice Address - Country:US
Practice Address - Phone:815-722-1818
Practice Address - Fax:815-722-2533
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360605632085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060563Medicaid
IL920005613OtherRR MEDICARE M&K RAD
IL300027716OtherRR MEDICARE RAD ONC KANKA
IL300034898OtherRR MEDICARE JOLIET RAD
K13082Medicare PIN
IL036060563Medicaid
K09102Medicare PIN