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1417680067
KASEM GHANNAM
CHICAGO, IL
NPI
1417680067
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 125081037)
Enumeration Date
2022-07-01
Last Update Date
2022-07-01
Business Address
KASEM GHANNAM D.O.
1969 W OGDEN AVE
CHICAGO, IL 60612-3765
Phone number: 312-864-6000
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Mailing Address
KASEM GHANNAM D.O.
1969 W OGDEN AVE
CHICAGO, IL 60612-3765
Phone number:
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