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General NPI Number Information
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NPI Number | 1033042809
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Entity Type | Organization
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Legal Business Name | ALJAZI MEDICAL GROUP LLC
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 3505 N PONTIAC AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2849
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Country | US
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Telephone | 312-610-2875
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Fax | 908-279-0587
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Provider Business Mailing Address
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Address Line | 3505 N PONTIAC AVE
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City | CHICAGO
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State | IL
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Zip | 60634-2849
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Country | US
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Telephone | 312-610-2875
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Fax | 908-279-0587
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Authorized Official
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Title or Position | NP/OWNER
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Name | KHADRA ALJAZI
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Credential | DNP
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Telephone | 312-610-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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