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General NPI Number Information
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NPI Number | 1326377896
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Entity Type | Organization
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Legal Business Name | MOBILE DOCTORS,INC
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Dates
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Enumeration Date | 12/13/2009
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Last Update Date | 12/13/2009
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Provider Practice Location Address
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Address Line | 131 E 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-3806
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Country | US
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Telephone | 773-624-0010
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Fax | 773-624-6080
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Provider Business Mailing Address
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Address Line | 131 E 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-3806
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Country | US
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Telephone | 773-624-0010
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Fax | 773-624-6080
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Authorized Official
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Title or Position | OWNER
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Name | MR. MUHAMMED HUMAYOUN
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Credential |
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Telephone | 219-678-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036.0117439
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License Number State | IL
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