MEDICARE: DR. MOHAMMED A ALAWAD 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	207R00000X	Internal Medicine Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1605130	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1952357436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMED A ALAWAD MD

Provider Business Mailing Address
First Line	:	9830 SOUTH RIDGELAND AVE
Second Line	:	SUITE 1
City	:	CHICAGO RIDGE
State	:	IL
Zip	:	60415-2667
Country	:	US
Telephone Number	:	708-425-0414
Fax Number	:	708-425-0229

Provider Business Practice Location Address
First Line	:	9830 SOUTH RIDGELAND AVE
Second Line	:	SUITE 1
City	:	CHICAGO RIDGE
State	:	IL
Zip	:	60415-2667
Country	:	US
Telephone Number	:	708-425-0414
Fax Number	:	708-425-0229

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/08/2007

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