MEDICARE: MOHAMMED KHALIDI

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1174404370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED KHALIDI

Provider Business Mailing Address
First Line	:	6735 N WASHTENAW AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4510
Country	:	US
Telephone Number	:	773-703-0061
Fax Number	:

Provider Business Practice Location Address
First Line	:	6735 N WASHTENAW AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4510
Country	:	US
Telephone Number	:	773-703-0061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2025
Last Update Date	:	09/12/2025

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Directions to “ MOHAMMED KHALIDI ” Practice Location

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