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General NPI Number Information
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NPI Number | 1366294811
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Entity Type | Organization
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Legal Business Name | GEMINI HEALTHCARE LLC
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 9150 CRAWFORD AVE STE L-6
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City | SKOKIE
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State | IL
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Zip | 60076-1700
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Country | US
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Telephone | 224-341-5331
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Fax | 224-341-7538
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Provider Business Mailing Address
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Address Line | 9150 CRAWFORD AVE STE L-6
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City | SKOKIE
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State | IL
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Zip | 60076-1700
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Country | US
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Telephone | 224-341-5331
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Fax | 224-341-7538
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Authorized Official
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Title or Position | PRESIDENT
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Name | FNU MOHAMMED MUQTADIR
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Credential |
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Telephone | 224-341-5331
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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