Organization
MAHAFZAH MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHMOUD MAHAFZAH MD, PH.D (OWNER)
(708) 422-1222
Entity
Organization
Contact information
Practice address
2850 W 95TH ST, 203, EVERGREEN PARK, IL 60805-2735
(708) 422-1222
(708) 422-5515
Mailing address
2850 W 95TH ST, 203, EVERGREEN PARK, IL 60805-2735
(708) 422-1222
(708) 422-5515
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1607612
BLUE SHIELD
IL
05
—
2077267
—
IL
Enumeration date
07/19/2006
Last updated
12/03/2009
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