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General NPI Number Information
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NPI Number | 1164556981
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Entity Type | Organization
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Legal Business Name | MEDWEST CONSULTATIONS,INC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 4754 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2010
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Country | US
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Telephone | 773-878-4000
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Fax | 773-878-4141
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Provider Business Mailing Address
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Address Line | 4754 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-2010
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Country | US
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Telephone | 773-878-4000
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Fax | 773-878-4141
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMJAD ZUREIKAT
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Credential | MD
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Telephone | 773-878-4000
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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 | 036061660
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License Number State | IL
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