Healthcare Provider Details

I. General information

NPI: 1063341683
Provider Name (Legal Business Name): MD HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SILVER CROSS BLVD STE 320
NEW LENOX IL
60451-9610
US

IV. Provider business mailing address

8535 142ND PL
ORLAND PARK IL
60462-4190
US

V. Phone/Fax

Practice location:
  • Phone: 708-945-2419
  • Fax:
Mailing address:
  • Phone: 708-945-2419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAZEN DIAB
Title or Position: PRESIDENT
Credential: MD
Phone: 708-945-2419