Individual
MOHAMED DAHODWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6441 S PULASKI RD, SUITE 100, CHICAGO, IL 60629-5148
(773) 284-1234
(773) 284-1811
Mailing address
PO BOX 64568, PHOENIX, AZ 85082-4568
(630) 288-6200
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036065163
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618378
BCBS PROVIDER ID
IL
01
—
01636774
BCBS PROVIDER ID
IL
05
—
036065163
—
IL
01
—
060012282
RAILROAD MEDICARE
IL
01
—
060053233
MEDICARE -- RR
IL
01
—
060053234
MEDICARE -- RR
IL
Enumeration date
07/21/2006
Last updated
09/25/2025
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