Healthcare Provider Details

I. General information

NPI: 1730228610
Provider Name (Legal Business Name): ALLERGY & ASTHMA CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 N COMMONWEALTH AVE FL 5
CHICAGO IL
60657-6211
US

IV. Provider business mailing address

2228 WEBER RD
CREST HILL IL
60435-0928
US

V. Phone/Fax

Practice location:
  • Phone: 815-729-9900
  • Fax: 815-729-9913
Mailing address:
  • Phone: 815-729-9900
  • Fax: 815-729-9913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number036-066748
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MAAZ MOHIUDDIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 815-729-9900