# SUBURBAN MEDICAL GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134824410
- **Authorized official:** MOHD MOHIUDDIN MD (PRESIDENT)
- **Authorized official phone:** (630) 360-2958

## Contact information

- **Practice address:** 200 N GARY AVE, CAROL STREAM, IL 60188-1834
- **Practice address phone:** (630) 326-8766
- **Practice address fax:** (630) 326-8768
- **Mailing address:** 200 N GARY AVE, CAROL STREAM, IL 60188-1834
- **Mailing address phone:** (630) 326-8766
- **Mailing address fax:** (630) 326-8768

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/04/2023
- **Last updated:** 05/10/2024