Provider Demographics
NPI:1891528980
Name:SALEM, AYUOB (RVT)
Entity type:Individual
Prefix:
First Name:AYUOB
Middle Name:
Last Name:SALEM
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 BROOKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2918
Mailing Address - Country:US
Mailing Address - Phone:708-971-3114
Mailing Address - Fax:
Practice Address - Street 1:6130 BROOKWOOD DR
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2918
Practice Address - Country:US
Practice Address - Phone:708-971-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty