Individual
DR. MOHAMMAD B HAIDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1340 CHARLES ST STE 100, ROCKFORD, IL 61104-2200
(779) 696-8700
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036156252
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2016
Last updated
08/04/2021
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