Healthcare Provider Details

I. General information

NPI: 1740106038
Provider Name (Legal Business Name): ALI ANJUM MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S WOOD ST MC 793
CHICAGO IL
60612
US

IV. Provider business mailing address

18 HSUKH CHAYN GARENS
LAHORE PUNJAB
54000
PK

V. Phone/Fax

Practice location:
  • Phone: 312-996-2933
  • Fax: 312-996-3050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number125.087118
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: