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NPI Code Detail

MEDICARE: MOHAMMAD ABOU EL-EZZ MD

MEDICARE: MOHAMMAD ABOU EL-EZZ 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
1208600000XSurgery PhysicianXXXIL

General Provider Information

NPI Number : 1790536746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMAD ABOU EL-EZZ MD
Provider Business Mailing Address
First Line : 3110 N SHERIDAN RD APT 1608
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4942
Country : US
Telephone Number : 606-425-7333
Fax Number :
Provider Business Practice Location Address
First Line : 2900 N LAKE SHORE DR
Second Line :
City : CHICAGO
State : IL
Zip : 60657-5640
Country : US
Telephone Number : 773-665-6237
Fax Number : 773-665-6232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2024
Last Update Date : 05/24/2026

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