Healthcare Provider Details

I. General information

NPI: 1508898362
Provider Name (Legal Business Name): MUHAMMAD ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WATERFORD DR
WILLOWBROOK IL
60527-5457
US

IV. Provider business mailing address

200 WATERFORD DR
WILLOWBROOK IL
60527-5457
US

V. Phone/Fax

Practice location:
  • Phone: 855-554-2545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.047765
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: