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NPI Code Detail

MEDICARE: MRS GHOUSIA B ALI MD & MOHAMMED MASOOD ALI MD

MEDICARE: MRS GHOUSIA B ALI MD & MOHAMMED MASOOD ALI MD
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
1207Q00000XFamily Medicine Physician036084980IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184804668
Entity Type Code : Organization
Provider Name (Legal Business Name) : MRS GHOUSIA B ALI MD & MOHAMMED MASOOD ALI MD
Provider Business Mailing Address
First Line : 5800 KEENEY ST
Second Line :
City : MORTON GROVE
State : IL
Zip : 60053-3551
Country : US
Telephone Number : 847-674-6611
Fax Number :
Provider Business Practice Location Address
First Line : 2040 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-2128
Country : US
Telephone Number : 773-274-3060
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. GHOUSIA BEGIM ALI
Credential : MD
Telephone Number : 773-274-3060
Provider Enumeration Date : 11/13/2007
Last Update Date : 08/13/2010

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