Healthcare Provider Details

I. General information

NPI: 1801197462
Provider Name (Legal Business Name): MIDWEST ALLERGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7808 W COLLEGE DR SUITE 1SW
PALOS HEIGHTS IL
60463-1027
US

IV. Provider business mailing address

10031 W ROOSEVELT RD STE 100
WESTCHESTER IL
60154-2669
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-0730
  • Fax: 708-361-0740
Mailing address:
  • Phone: 708-344-3550
  • Fax: 708-344-6577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number036-050567
License Number StateIL

VIII. Authorized Official

Name: MS. MUHAMMAD GHANI
Title or Position: PHYSICIAN
Credential: MD
Phone: 708-344-3550