MEDICARE: DR. MAAHA AYUB MBBS

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	125086381	IL

General Provider Information

NPI Number	:	1508753872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAAHA AYUB MBBS

Provider Business Mailing Address
First Line	:	701 N 1 ST ST., P. O. BOX 19636 SPRINGFIELD, IL 62794-9
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62794-9636
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-9730

Provider Business Practice Location Address
First Line	:	701 N 1 ST ST., P. O. BOX 19636 SPRINGFIELD, IL 62794-9
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62794-9636
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-9730

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

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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