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Organization
ANN MEDICAL CENTER SC
Active
Organization
ANN MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANJUM HAMEEDUDDIN M.D. (OWNER)
(708) 747-7720
Entity
Organization
Contact information
Practice address
4647 LINCOLN HWY, MATTESON, IL 60443-2319
(708) 747-7720
(708) 915-7239
Mailing address
PO BOX 250, MATTESON, IL 60443-0250
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-051648
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051648
—
IL
01
—
1632848
BCBSIL GROUP #
IL
Enumeration date
06/09/2006
Last updated
11/25/2009
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