MEDICARE: DR. HOWIDE ELDIB MD,MS

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	125073561	IL

General Provider Information

NPI Number	:	1275191736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWIDE ELDIB MD,MS

Provider Business Mailing Address
First Line	:	2160 S 1ST AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-3328
Country	:	US
Telephone Number	:	708-202-8387
Fax Number	:

Provider Business Practice Location Address
First Line	:	4728 LYNDALE AVE S APT 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55419-5304
Country	:	US
Telephone Number	:	952-393-2013
Fax Number	:

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

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	09/03/2019

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