MEDICARE: MAZEN KHUBIEH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036.174993	IL

General Provider Information

NPI Number	:	1043147515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAZEN KHUBIEH

Provider Business Mailing Address
First Line	:	8150 185TH ST STE A
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60487-9319
Country	:	US
Telephone Number	:	708-444-0444
Fax Number	:

Provider Business Practice Location Address
First Line	:	8150 185TH ST STE A
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60487-9319
Country	:	US
Telephone Number	:	708-444-0444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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Directions to “ MAZEN KHUBIEH ” Practice Location

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