MEDICARE: DR. RIMA MCLEOD M.D.

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	207RI0200X	Infectious Disease Physician	036-057438	IL
2	207RI0200X	Infectious Disease Physician	G-24147	CA

General Provider Information

NPI Number	:	1205950458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIMA MCLEOD M.D.

Provider Business Mailing Address
First Line	:	5729 S KIMBARK AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:	S-206, MC 2114
City	:	CHICAGO
State	:	IL
Zip	:	60637-1447
Country	:	US
Telephone Number	:	773-834-4130
Fax Number	:	773-834-3577

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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