Healthcare Provider Details
I. General information
NPI: 1124993514
Provider Name (Legal Business Name): DOOSAM INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 W GRAND AVE FL 1
BENSENVILLE IL
60106-3364
US
IV. Provider business mailing address
205 W GRAND AVE FL 1
BENSENVILLE IL
60106-3364
US
V. Phone/Fax
- Phone: 551-344-7630
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FNU
MOHAMMED MASOOD
Title or Position: MANAGER
Credential:
Phone: 551-344-7630