MEDICARE: ADEEBUR RAHMAN MD SC

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	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1033263371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADEEBUR RAHMAN MD SC

Provider Business Mailing Address
First Line	:	9133 S STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3512
Country	:	US
Telephone Number	:	773-375-3911
Fax Number	:	847-375-2334

Provider Business Practice Location Address
First Line	:	9133 S STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-3512
Country	:	US
Telephone Number	:	773-375-3911
Fax Number	:	847-375-2334

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ADEEBUR RAHMAN
Credential	:	M.D.
Telephone Number	:	773-375-3911

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	08/22/2020

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