Healthcare Provider Details

I. General information

NPI: 1619235264
Provider Name (Legal Business Name): AYEZA MOHSIN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 N HIGHLAND AVE
AURORA IL
60506-1404
US

IV. Provider business mailing address

2357 SEQUOIA DR
AURORA IL
60506-6222
US

V. Phone/Fax

Practice location:
  • Phone: 630-699-8306
  • Fax:
Mailing address:
  • Phone: 630-859-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036138645
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.138645
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: