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General NPI Number Information
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NPI Number | 1144955063
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Entity Type | Individual
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Provider Name | SAAD MUTTAR MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2022
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Last Update Date | 07/24/2022
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Provider Practice Location Address
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Address Line | 4001 W DEVON AVE STE 507
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City | CHICAGO
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State | IL
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Zip | 60646-4540
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Country | US
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Telephone | 773-853-0857
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Fax | 872-804-2266
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Provider Business Mailing Address
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Address Line | 10044 BRONX AVE
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City | SKOKIE
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State | IL
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Zip | 60077-1002
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Country | US
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Telephone | 872-235-8881
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00000000000
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License Number State | IL
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