MEDICARE: ALJAZI MEDICAL GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1033042809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALJAZI MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	3505 N PONTIAC AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-2849
Country	:	US
Telephone Number	:	312-610-2875
Fax Number	:	908-279-0587

Provider Business Practice Location Address
First Line	:	3505 N PONTIAC AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-2849
Country	:	US
Telephone Number	:	312-610-2875
Fax Number	:	908-279-0587

Authorized Official
Title or Position	:	NP/OWNER
Name	:	KHADRA ALJAZI
Credential	:	DNP
Telephone Number	:	312-610-2875

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ALJAZI MEDICAL GROUP LLC ” Practice Location

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