Organization
SUBURBAN MEDICAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHD MOHIUDDIN MD (PRESIDENT)
(630) 360-2958
Entity
Organization
Contact information
Practice address
200 N GARY AVE, CAROL STREAM, IL 60188-1834
(630) 326-8766
(630) 326-8768
Mailing address
200 N GARY AVE, CAROL STREAM, IL 60188-1834
(630) 326-8766
(630) 326-8768
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
04/04/2023
Last updated
05/10/2024
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