Individual
MRS. FATIMA M MOHIUDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9120 W GOLF RD, NILES, IL 60714-5806
(847) 390-7122
(847) 390-7115
Mailing address
2740 W FOSTER AVE, STE LL7, CHICAGO, IL 60625-3543
(773) 878-8200
(773) 293-4197
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036092848
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092848
—
IL
01
—
21621391
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
09/27/2006
Last updated
01/14/2016
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