Healthcare Provider Details

I. General information

NPI: 1225951353
Provider Name (Legal Business Name): ABDUL MOHAMMED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9002 SENATE DR APT 2G
DES PLAINES IL
60016-5067
US

IV. Provider business mailing address

9002 SENATE DR APT 2G
DES PLAINES IL
60016-5067
US

V. Phone/Fax

Practice location:
  • Phone: 773-564-0949
  • Fax:
Mailing address:
  • Phone: 773-564-0949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number15609885
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: