| NPI | 1043718190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED S SIRAJUDEEN Manager 773-552-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-06-16 |