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NPI Code Detail

MEDICARE: KHAJA ALIUDDIN MD SC

MEDICARE: KHAJA ALIUDDIN MD SC
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 PhysicianIL

General Provider Information

NPI Number : 1871767111
Entity Type Code : Organization
Provider Name (Legal Business Name) : KHAJA ALIUDDIN MD SC
Provider Business Mailing Address
First Line : 3147 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3307
Country : US
Telephone Number : 773-522-1216
Fax Number : 773-522-9660
Provider Business Practice Location Address
First Line : 3147 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3307
Country : US
Telephone Number : 773-522-1216
Fax Number : 773-522-9660
Authorized Official
Title or Position : PHYSICIAN/PRESIDENT
Name : DR. KHAJA ALIUDDIN
Credential : M.D.
Telephone Number : 773-522-1216
Provider Enumeration Date : 04/17/2008
Last Update Date : 04/17/2008

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Directions to “KHAJA ALIUDDIN MD SC ” Practice Location

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