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Organization
KIDNEY SPECIALISTS OF ILLINOIS LLC
Active
Organization
KIDNEY SPECIALISTS OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSTAFA MOHAMMED ALI M.D. (OWNER)
(847) 942-6848
Entity
Organization
Contact information
Practice address
5140 N CALIFORNIA AVE, SUITE 700, CHICAGO, IL 60625-3645
(773) 784-2101
(773) 784-0771
Mailing address
5140 N CALIFORNIA AVE, SUITE 700, CHICAGO, IL 60625-3645
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036.125203
IL
Other
Enumeration date
09/23/2013
Last updated
02/03/2014
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