Healthcare Provider Details

I. General information

NPI: 1265172985
Provider Name (Legal Business Name): SABAH MAHMOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 CHURCHVIEW DR
ROCKFORD IL
61107-2574
US

IV. Provider business mailing address

7900 W LAWRENCE AVE UNIT E
NORRIDGE IL
60706-3248
US

V. Phone/Fax

Practice location:
  • Phone: 815-971-8990
  • Fax: 815-971-9978
Mailing address:
  • Phone: 773-817-9526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036172389
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036172389
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: