MEDICARE: DR. NOURA CHOUDHURY 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	207R00000X	Internal Medicine Physician	298504-1	NY
2	207RX0202X	Medical Oncology Physician	036170553	IL

General Provider Information

NPI Number	:	1841649332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NOURA CHOUDHURY M.D.

Provider Business Mailing Address
First Line	:	150 HARVESTER DR STE 300
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5965
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:	DEPARTMENT OF INTERNAL MEDICINE, M/C 7082
City	:	CHICAGO
State	:	IL
Zip	:	60637-1447
Country	:	US
Telephone Number	:	773-795-0232
Fax Number	:	773-702-2230

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

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	06/04/2026

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