MEDICARE: QUALITY MEDICAL INC

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	302F00000X	Exclusive Provider Organization	036056607	IL

General Provider Information

NPI Number	:	1063834232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY MEDICAL INC

Provider Business Mailing Address
First Line	:	4708 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-4421
Country	:	US
Telephone Number	:	773-583-7420
Fax Number	:

Provider Business Practice Location Address
First Line	:	4708 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-4421
Country	:	US
Telephone Number	:	773-583-7420
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TAMER ALRIFAI
Credential	:	M.D.
Telephone Number	:	773-583-7420

Provider Enumeration Date	:	01/07/2014
Last Update Date	:	01/07/2014

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Directions to “QUALITY MEDICAL INC ” Practice Location

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