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General NPI Number Information
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NPI Number | 1477500056
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Entity Type | Individual
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Provider Name | ABDUL HUSSEIN ALI MAZIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1801 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-4795
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Country | US
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Telephone | 312-996-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 2160 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-3328
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Country | US
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Telephone | 708-216-9000
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036118947
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 036118947
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35C.000633
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2023-03260
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 3035
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 036118947
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 036118947
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036118947
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License Number State | IL
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