Mr Mahamid Ali Khan, DMD | |
6447 Cermak Rd, Berwyn, IL 60402-2311 | |
(773) 254-1400 | |
(312) 829-6375 |
Full Name | Mr Mahamid Ali Khan |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 6447 Cermak Rd, Berwyn, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164424016 | NPI | - | NPPES |
019024670 | Medicaid | IL | |
407262500 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 2005002250 (Missouri) | Secondary |
122300000X | Dentist | 019024670 (Illinois) | Primary |
Entity Name | Alivio Medical Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083860845 PECOS PAC ID: 5698840924 Enrollment ID: O20081114000791 |
Mailing Address | Practice Location Address |
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Mr Mahamid Ali Khan, DMD 966 W 21st St, Chicago, IL 60608-4511 Ph: (773) 254-1400 | Mr Mahamid Ali Khan, DMD 6447 Cermak Rd, Berwyn, IL 60402-2311 Ph: (773) 254-1400 |
Dr. Margaret Anne Vizgirda, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 6600 26th St, Berwyn, IL 60402 Phone: 708-788-6600 Fax: 708-788-0432 | |
Mahmood Hassan Ali Haider Al Gailani, Dentist Medicare: Not Enrolled in Medicare Practice Location: 6301 Cermak Rd Ste B, Berwyn, IL 60402 Phone: 708-956-7516 | |
Dr. Daniel Mark Salerno, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6436 West Cermak Rd, Berwyn, IL 60402 Phone: 708-484-2710 Fax: 708-484-2702 | |
Dr. Ladd Joseph Kulhanek, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6642 Cermak Rd, Berwyn, IL 60402 Phone: 708-749-3222 | |
Dr. Marsha A Babka, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2841 Home Ave, Berwyn, IL 60402 Phone: 708-484-3736 | |
Young Shin, DDS Dentist Medicare: Medicare Enrolled Practice Location: 6201 Roosevelt Rd, Berwyn, IL 60402 Phone: 708-386-0845 Fax: 708-386-8472 | |
Dr. Claudia Rae Romanek, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6642 Cermak Rd, Berwyn, IL 60402 Phone: 708-749-3222 |