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NPI Code Detail

MEDICARE: DR. MOHAMMAD MASOOD ALI MD

MEDICARE: DR. MOHAMMAD MASOOD ALI 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
1207Q00000XFamily Medicine Physician036075613IL

Other Identifiers

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

General Provider Information

NPI Number : 1750383758
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMMAD MASOOD ALI MD
Provider Business Mailing Address
First Line : 2040 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-2128
Country : US
Telephone Number : 847-769-5858
Fax Number :
Provider Business Practice Location Address
First Line : 2040 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-2128
Country : US
Telephone Number : 773-274-3060
Fax Number : 773-274-3081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 10/24/2014

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