| NPI | 1245428374 |
|---|---|
| Doing Business As | SHAKIR MOIDUDDIN |
| Entity Type | Organization |
| Authorized Contact | SHAKIR MOIDUDDIN Medical Director 708-361-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036052775) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |