Healthcare Provider Details

I. General information

NPI: 1114358017
Provider Name (Legal Business Name): MARCON MEDICAL PARTNERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 12/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 N MCLEAN BLVD UNIT C
ELGIN IL
60123-1782
US

IV. Provider business mailing address

1140 N MCLEAN BLVD UNIT C
ELGIN IL
60123-1782
US

V. Phone/Fax

Practice location:
  • Phone: 224-558-5493
  • Fax:
Mailing address:
  • Phone: 224-558-5493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036117058
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number085002516
License Number StateIL

VIII. Authorized Official

Name: DR. SAJJAD MURTAZA
Title or Position: PHYSICIAN
Credential: MD
Phone: 847-971-8991