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NPI Code Detail

MEDICARE: MOHAMMAD ALI AL MAHDAWI M.D

MEDICARE: MOHAMMAD ALI AL MAHDAWI 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
1207R00000XInternal Medicine Physician01088553AIN
2207R00000XInternal Medicine Physician4301506423MI
3390200000XStudent in an Organized Health Care Education/Training Program
4207RN0300XNephrology Physician01088553AIN

General Provider Information

NPI Number : 1992236749
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMMAD ALI AL MAHDAWI M.D
Provider Business Mailing Address
First Line : 120 W 22ND ST
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1557
Country : US
Telephone Number : 630-573-5000
Fax Number :
Provider Business Practice Location Address
First Line : 7836 W JEFFERSON BLVD STE 101
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4178
Country : US
Telephone Number : 260-494-3484
Fax Number : 260-969-0188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2017
Last Update Date : 05/07/2025

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