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Organization
UNIVERSAL MEDICAL & REHABILITATION CENTER, S.C.
Active
Organization
UNIVERSAL MEDICAL & REHABILITATION CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATIMA M MOHIUDDIN M.D. (PRESIDENT)
18473907122
Entity
Organization
Contact information
Practice address
2828 W DEVON AVE, CHICAGO, IL 60659-1502
(773) 761-9774
(773) 761-9878
Mailing address
9120 W GOLF RD, NILES, IL 60714-5806
(847) 390-7122
(847) 390-7115
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030004494
RAILROAD MEDICARE
IL
05
—
036079439
—
IL
05
—
036092848
—
IL
01
—
0404246
UNITEDHEALTHCARE
IL
01
—
110239089
RAILROAD MEDICARE
IL
01
—
1156492
FIRST HEALTH
IL
01
—
21621391
BLUE CROSS/BLUE SHIELD
IL
01
—
250733
HARMONY
IL
05
—
328026621001
—
IL
05
—
335989271001
—
IL
01
—
4140282
AETNA
IL
Enumeration date
12/27/2007
Last updated
12/27/2007
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