Awni Omar Daoud

Individual provider Active NPI Prevention Professional · Bridgeview, IL

NPI 1689440877 · NPPES record last updated Nov 29, 2023

Key facts

NPI
1689440877
Entity type
Individual (NPI type 1)
Primary specialty
Prevention Professional 405300000X
License
D300-0145-8023 (IL)
Practice address
9100 Beloit Ave
Bridgeview, IL 60455-2605
Phone
(708) 655-3008
NPI assigned
Nov 29, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D30001458023ILMDTaxi
D300-0145-8023ILMDPrevention Professional

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Taxi 344600000X D30001458023 IL
Taxi 344600000X
Prevention Professional 405300000X D300-0145-8023 IL Yes

Addresses

Primary practice location

9100 Beloit Ave
Bridgeview, IL 60455-2605

Mailing address

9100 Beloit Ave
Bridgeview, IL 60455-2605
Phone (708) 655-3008

Other providers in Bridgeview, IL

All providers in Bridgeview, IL · Prevention Professional in Illinois

Sources for this page

Verify at the official NPI Registry.