Provider Demographics
NPI:1629958962
Name:GRANULAR CARE, PLLC
Entity type:Organization
Organization Name:GRANULAR CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR, NP
Authorized Official - Prefix:
Authorized Official - First Name:LAMEES
Authorized Official - Middle Name:NEMER
Authorized Official - Last Name:MAHMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:847-957-6014
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-0171
Mailing Address - Country:US
Mailing Address - Phone:847-957-6014
Mailing Address - Fax:847-385-3672
Practice Address - Street 1:11319 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-2001
Practice Address - Country:US
Practice Address - Phone:847-957-6014
Practice Address - Fax:847-385-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty