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General NPI Number Information
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NPI Number | 1023053808
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Entity Type | Individual
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Provider Name | MOHAMMED AZHER KASSEM M.D
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 1501 S CALIFORNIA AVE MT SINAI HOSPITAL, CANCER CARE CENTER
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City | CHICAGO
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State | IL
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Zip | 60608-1732
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Country | US
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Telephone | 773-257-6120
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 S CALIFORNIA AV MT SINAI HOSPITAL , CANCER CARE CENTER, 6TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60608-9025
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Country | US
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Telephone | 773-257-6120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036-112270
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License Number State | IL
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