Basic Information
| Provider Information | |||||||||
| NPI: | 1740344241 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISSA | ||||||||
| FirstName: | NABIL | ||||||||
| MiddleName: | MOHAMED | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 676 N SAINT CLAIR ST | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126954835 | ||||||||
| FaxNumber: | 3126953644 | ||||||||
| Practice Location | |||||||||
| Address1: | 676 N SAINT CLAIR ST | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606112927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126954835 | ||||||||
| FaxNumber: | 3126953644 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2006 | ||||||||
| LastUpdateDate: | 08/17/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | 35083861 | OH | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0102X | 036119396 | IL | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | 036119396 | IL | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 4301088782 | MI | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.