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NPI Code Detail

MEDICARE: INNER-CITY MUSLIM ACTION NETWORK

MEDICARE: INNER-CITY MUSLIM ACTION NETWORK
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker
32083P0901XPublic Health & General Preventive Medicine Physician
4207Q00000XFamily Medicine Physician
5207R00000XInternal Medicine Physician
6363A00000XPhysician Assistant
72084P0800XPsychiatry Physician
8261QF0400XFederally Qualified Health Center (FQHC)IL

General Provider Information

NPI Number : 1386137925
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER-CITY MUSLIM ACTION NETWORK
Provider Business Mailing Address
First Line : 2744 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-2343
Country : US
Telephone Number : 773-434-4626
Fax Number : 773-303-8858
Provider Business Practice Location Address
First Line : 2744 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-2343
Country : US
Telephone Number : 773-434-4626
Fax Number : 773-303-8858
Authorized Official
Title or Position : INTERIM BOARD CHAIR
Name : SYEDA KAMRAN
Credential :
Telephone Number : 773-434-4626
Provider Enumeration Date : 06/08/2018
Last Update Date : 06/17/2026

Similar Medicare Providers

1003244567 — INNER-CITY MUSLIM ACTION NETWORK
Practice Location Address:
2744 W 63RD ST
CHICAGO, IL
60629-2343
Practice Phone: 773-434-4626
Practice Fax: 773-776-3623
1164455978 — MOHAMMED ALTAF KAISERUDDIN MD
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Practice Fax:
1699873398 — MRS. SUSAN KILLRAKIS FNP
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2744 W 63RD ST
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60629-2343
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Practice Fax:
1366642357 — DR. MICHELLE E ANDERSON PHD
Practice Location Address:
2744 W 63RD ST , BEHAVIOR HEALTH
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60629-2343
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Practice Fax:
1558719344 — NATALI Y REHMAN LMFT
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60629-2343
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1770020828 — INNER-CITY MUSLIM ACTION NETWORK
Practice Location Address:
2744 W 63RD ST
CHICAGO, IL
60629-2343
Practice Phone: 773-434-4626
Practice Fax: 773-776-3623

Directions to “INNER-CITY MUSLIM ACTION NETWORK ” Practice Location

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