MEDICARE: MRS. SARAH MOH'D AL SHAFI MOH'D AL ZOUBI M.D

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	246ZN0300X	Nephrology Specialist/Technologist	125082973	IL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1568148989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH MOH'D AL SHAFI MOH'D AL ZOUBI M.D

Provider Business Mailing Address
First Line	:	150 FOREST AVE UNIT 627
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60301-1441
Country	:	US
Telephone Number	:	773-750-2453
Fax Number	:

Provider Business Practice Location Address
First Line	:	GME. 820 S. WOODS STREET
Second Line	:	SUITE 100, MC 675
City	:	CHICAGO
State	:	IL
Zip	:	60612
Country	:	US
Telephone Number	:	312-996-2933
Fax Number	:	312-996-3050

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

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	01/12/2026

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