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General NPI Number Information
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NPI Number | 1770928640
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Entity Type | Individual
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Provider Name | SHOEB MOHIUDDIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 1658 N MILWAUKEE AVE # 295
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City | CHICAGO
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State | IL
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Zip | 60647-6905
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Country | US
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Telephone | 312-300-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 W TAYLOR ST 3200W UIH M/C515
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 312-996-4021
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036140752
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036140752
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License Number State | IL
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