Provider Demographics
NPI:1194745018
Name:ABDELHAMID, ASHRAF (PT MS OCS)
Entity type:Individual
Prefix:
First Name:ASHRAF
Middle Name:
Last Name:ABDELHAMID
Suffix:
Gender:M
Credentials:PT MS OCS
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 228
Mailing Address - Street 2:
Mailing Address - City:WILLOW SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60480-0228
Mailing Address - Country:US
Mailing Address - Phone:630-371-1623
Mailing Address - Fax:630-371-1546
Practice Address - Street 1:7055 HIGH GROVE BLVD
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7628
Practice Address - Country:US
Practice Address - Phone:630-371-1623
Practice Address - Fax:630-371-1546
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007180225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL96515Medicare UPIN