MEDICARE: MIDWEST ENDOCRINE & DIABETES CARE LLC

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036101521	IL

General Provider Information

NPI Number	:	1871823872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST ENDOCRINE & DIABETES CARE LLC

Provider Business Mailing Address
First Line	:	16W741 90TH ST
Second Line	:
City	:	WILLOWBROOK
State	:	IL
Zip	:	60527-6086
Country	:	US
Telephone Number	:	630-323-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	6827 KINGERY HWY
Second Line	:
City	:	WILLOWBROOK
State	:	IL
Zip	:	60527-5154
Country	:	US
Telephone Number	:	630-323-2455
Fax Number	:

Authorized Official
Title or Position	:	ENDOCRINOLOGIST
Name	:	DR. UZMA NAEEM SYED
Credential	:	M.D.
Telephone Number	:	630-323-2455

Provider Enumeration Date	:	01/13/2010
Last Update Date	:	01/13/2010

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