MEDICARE: SYED AZHAR MOHIUDDIN 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	2085R0204X	Vascular & Interventional Radiology Physician	036.146119	IL
2	2085R0202X	Diagnostic Radiology Physician	036146119	IL

General Provider Information

NPI Number	:	1619210820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED AZHAR MOHIUDDIN M.D.

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 HIGHLAND AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1500
Country	:	US
Telephone Number	:	630-275-5900
Fax Number	:

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

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	03/06/2026

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