Provider Demographics
NPI:1427801604
Name:IJM HOLDINGS LTD
Entity type:Organization
Organization Name:IJM HOLDINGS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MAHMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:478-410-6951
Mailing Address - Street 1:8705 S ROBERTS RD APT 1
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1375
Mailing Address - Country:US
Mailing Address - Phone:478-410-6951
Mailing Address - Fax:
Practice Address - Street 1:6195 W 115TH ST STE B
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-5153
Practice Address - Country:US
Practice Address - Phone:478-410-6951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty