Provider Demographics
NPI:1912912445
Name:ABUSHARIF, HAMDALA HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:HAMDALA
Middle Name:HENRY
Last Name:ABUSHARIF
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 1:12766 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2145
Mailing Address - Country:US
Mailing Address - Phone:708-448-2626
Mailing Address - Fax:708-448-0630
Practice Address - Street 1:12766 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2145
Practice Address - Country:US
Practice Address - Phone:708-448-2626
Practice Address - Fax:708-448-0630
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine