Healthcare Provider Details

I. General information

NPI: 1194739268
Provider Name (Legal Business Name): MUHAMMAD T K GHANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number036050567
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number036050567
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: