MEDICARE: MAHUM MIRZA DO

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	125.075884	IL
2	207R00000X	Internal Medicine Physician	036-162479	IL

General Provider Information

NPI Number	:	1992333686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHUM MIRZA DO

Provider Business Mailing Address
First Line	:	PO BOX 713260
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-1260
Country	:	US
Telephone Number	:	630-469-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 N CASS AVE STE 150
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1121
Country	:	US
Telephone Number	:	630-268-0200
Fax Number	:	630-963-6579

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

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	10/03/2025

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Directions to “ MAHUM MIRZA DO” Practice Location

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