Mohammad A Razzaque Md,ltd | |
3228 W 95th St Evergreen Park IL 60805-2314 | |
(708) 425-4800 | |
(708) 422-6534 |
Full Name | Mohammad A Razzaque Md,ltd |
---|---|
Speciality | Internal Medicine |
Location | 3228 W 95th St, Evergreen Park, Illinois |
Authorized Official Name and Position | Mohammad A Razzaque (PRESIDENT) |
Authorized Official Contact | 7084254800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mohammad A Razzaque Md,ltd 3228 W 95th St Evergreen Park IL 60805-2314 Ph: () - | Mohammad A Razzaque Md,ltd 3228 W 95th St Evergreen Park IL 60805-2314 Ph: (708) 425-4800 |
NPI Number | 1659587954 |
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Provider Enumeration Date | 05/15/2007 |
Last Update Date | 08/13/2024 |
Medicare PECOS PAC ID | 8224064142 |
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Medicare Enrollment ID | O20050712001056 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659587954 | NPI | - | NPPES |
P00036664 | Other | IL | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036089799 (Illinois) | Primary |
Provider Name | Mohammad A Razzaque |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184683849 PECOS PAC ID: 4183650005 Enrollment ID: I20050721000500 |
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