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NPI Code Detail

MEDICARE: DR. MUNAWAR SULTANA M.D

MEDICARE: DR. MUNAWAR SULTANA 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
1261QF0400XFederally Qualified Health Center (FQHC)036130663IL
2207Q00000XFamily Medicine Physician036130663IL

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 : 1396978979
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MUNAWAR SULTANA M.D
Provider Business Mailing Address
First Line : 1120 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-4767
Country : US
Telephone Number : 847-342-1554
Fax Number : 608-371-8938
Provider Business Practice Location Address
First Line : 1120 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-4767
Country : US
Telephone Number : 847-342-1554
Fax Number : 608-371-8938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2009
Last Update Date : 07/16/2024

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