Physician Compare National (NPI:1043230857)

HEALTHCARE PROVIDER: MOHAMED DAHODWALA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1043230857
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860394962
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050727000086
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAHODWALA
	Individual professional last name
Provider First Name	MOHAMED
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6441 S PULASKI RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606295148
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140095
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT ANTHONY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140133
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOLY CROSS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140083
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LORETTO HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y