Provider Demographics
NPI:1194745422
Name:DABBAH, SAOUD (MD)
Entity type:Individual
Prefix:DR
First Name:SAOUD
Middle Name:
Last Name:DABBAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAOUD
Other - Middle Name:
Other - Last Name:DABBAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4941 N KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5009
Mailing Address - Country:US
Mailing Address - Phone:773-588-7600
Mailing Address - Fax:773-509-9886
Practice Address - Street 1:4941 N KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5009
Practice Address - Country:US
Practice Address - Phone:773-588-7600
Practice Address - Fax:773-509-9886
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U91982Medicare UPIN
IL202853Medicare ID - Type UnspecifiedMEDICARE GROUP