| Mohtasham Mohiuddin Pc | |
|
2701 W 68th St Chicago IL 60629-1813 | |
| (773) 884-9000 | |
| Not Available |
| Full Name | Mohtasham Mohiuddin Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2701 W 68th St, Chicago, Illinois |
| Authorized Official Name and Position | Mohtasham M Mohiuddin (PRESIDENT) |
| Authorized Official Contact | 7184401826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohtasham Mohiuddin Pc 5005 Warren St # 607 Skokie IL 60077-2986 Ph: (718) 440-1826 | Mohtasham Mohiuddin Pc 2701 W 68th St Chicago IL 60629-1813 Ph: (773) 884-9000 |
| NPI Number | 1194136291 |
|---|---|
| Provider Enumeration Date | 05/12/2014 |
| Last Update Date | 05/12/2014 |
| Medicare PECOS PAC ID | 3870717747 |
|---|---|
| Medicare Enrollment ID | O20140616001109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194136291 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Mohtasham M Mohiuddin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518166461 PECOS PAC ID: 5799873550 Enrollment ID: I20110315000239 |
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