# MOHAMMAD A MIRZA MD SC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MA Mirza MD SC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013038512
- **Authorized official:** MOHAMMAD A MIRZA MD (PRESIDENT)
- **Authorized official phone:** (773) 735-4600

## Contact information

- **Practice address:** 6723 S PULASKI ROAD, CHICAGO, IL 60629-4118
- **Practice address phone:** (773) 735-4600
- **Practice address fax:** (773) 735-3112
- **Mailing address:** 6723 S PULASKI ROAD, CHICAGO, IL 60629-4118
- **Mailing address phone:** (773) 735-4600
- **Mailing address fax:** (773) 735-3112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | IL | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 08/22/2020