MEDICARE: SALEEM MAHMOOD MD

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	2085R0001X	Radiation Oncology Physician	MD-14509	HI
2	2085R0001X	Radiation Oncology Physician	R5P72	MO
3	2085R0001X	Radiation Oncology Physician	036091247	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679677678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALEEM MAHMOOD MD

Provider Business Mailing Address
First Line	:	PO BOX 483
Second Line	:
City	:	LITCHFIELD
State	:	IL
Zip	:	62056-0483
Country	:	US
Telephone Number	:	217-324-1100
Fax Number	:	217-324-1103

Provider Business Practice Location Address
First Line	:	1201 E UNION AVE
Second Line	:
City	:	LITCHFIELD
State	:	IL
Zip	:	62056-1700
Country	:	US
Telephone Number	:	217-324-1100
Fax Number	:	217-324-1103

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	02/09/2023

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