MEDICARE: MIDWEST MEDICAL ASSOCIATES 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1225548696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST MEDICAL ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	1440 W NORTH AVE STE 305
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1426
Country	:	US
Telephone Number	:	708-338-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 W NORTH AVE STE 305
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1426
Country	:	US
Telephone Number	:	708-338-1000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HEMA AZAD
Credential	:	MD
Telephone Number	:	708-338-1000

Provider Enumeration Date	:	10/11/2017
Last Update Date	:	10/25/2019

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