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NPI Code Detail

MEDICARE: DR. MUHYALDEEN DIA MD,FACC

MEDICARE: DR. MUHYALDEEN DIA MD,FACC
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
1207RC0000XCardiovascular Disease Physician036-088800IL
2207RA0001XAdvanced Heart Failure and Transplant Cardiology Physician036-088800IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060053842OTHERILPALMETTO GBA INDIVIDUAL #
2CI8250OTHERILPALMETTO GBA GROUP #
321622931OTHERILBCBS GROUP #
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851384663
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MUHYALDEEN DIA MD,FACC
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10837 S CICERO AVE STE 200
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-6459
Country : US
Telephone Number : 708-636-7575
Fax Number : 708-636-6193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 02/17/2025

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