MEDICARE: ALLERGY & ASTHMA CENTER, INC

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	261Q00000X	Clinic/Center	036-066748	IL
2	207K00000X	Allergy & Immunology Physician

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
2	4047673	OTHER	IL	CIGNA
3	794184	OTHER	IL	FIRST HEALTH
4	31603308	OTHER	IL	BLUE CROSS
5	788313	OTHER	IL	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1730228610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY & ASTHMA CENTER, INC

Provider Business Mailing Address
First Line	:	2228 WEBER RD
Second Line	:
City	:	CREST HILL
State	:	IL
Zip	:	60435-0928
Country	:	US
Telephone Number	:	815-729-9900
Fax Number	:	815-729-9913

Provider Business Practice Location Address
First Line	:	2913 N COMMONWEALTH AVE FL 5
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-6211
Country	:	US
Telephone Number	:	815-729-9900
Fax Number	:	815-729-9913

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MAAZ MOHIUDDIN
Credential	:	M.D.
Telephone Number	:	815-729-9900

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	02/06/2025

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