MEDICARE: DR. SAJJAD MURTAZA 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	208VP0014X	Interventional Pain Medicine Physician	036-117058	IL
2	208100000X	Physical Medicine & Rehabilitation Physician	4301086836	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4301086836	OTHER	MI	BOARD OF MEDICINE LICENSE
2	036117058	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1881656049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAJJAD MURTAZA MD

Provider Business Mailing Address
First Line	:	820 W JACKSON BLVD
Second Line	:	SUITE 310
City	:	CHICAGO
State	:	IL
Zip	:	60607-3026
Country	:	US
Telephone Number	:	312-757-4647
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 W JACKSON BLVD
Second Line	:	SUITE 310
City	:	CHICAGO
State	:	IL
Zip	:	60607-3026
Country	:	US
Telephone Number	:	312-757-4647
Fax Number	:

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	06/28/2022

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