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General NPI Number Information
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NPI Number | 1700238813
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Entity Type | Individual
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Provider Name | SAJID MAHMOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 3505 GREEN BAY RD 304A
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3607
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Country | US
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Telephone | 312-385-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 3505A GREEN BAY RD APT 304A
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City | NORTH CHICAGO
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State | IL
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Zip | 60064
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Country | US
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Telephone | 312-385-9432
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.069383
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036148947
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License Number State | IL
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