MEDICARE: RAKHSHANDA M. MUNIR 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	261Q00000X	Clinic/Center	036094551	IL

General Provider Information

NPI Number	:	1356590517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAKHSHANDA M. MUNIR MD SC

Provider Business Mailing Address
First Line	:	4438 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-3743
Country	:	US
Telephone Number	:	773-794-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4438 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-3743
Country	:	US
Telephone Number	:	773-794-2100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAKHSHANDA M. MUNIR
Credential	:	MD
Telephone Number	:	773-794-2100

Provider Enumeration Date	:	09/11/2008
Last Update Date	:	10/06/2008

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