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General NPI Number Information
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NPI Number | 1730968397
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Entity Type | Individual
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Provider Name | MOHAMMED MIQDAD MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2023
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1009 S WOOD ST
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City | CHICAGO
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State | IL
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Zip | 60612-3747
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Country | US
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Telephone | 886-600-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 N LAWNDALE AVE APT 1F
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City | CHICAGO
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State | IL
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Zip | 60651-2261
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Country | US
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Telephone | 929-683-3972
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 125.085108
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License Number State | IL
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