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Individual

RAFIYA HAMEEDUDDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2650 RIDGE AVE., IM HOSPITALISTS STE 4210, EVANSTON, IL 60201
(847) 570-1010
(847) 733-5108
Mailing address
2650 RIDGE AVE., IM HOSPITALISTS STE 4210, EVANSTON, IL 60201
(847) 570-1010
(847) 733-5108

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036091808
IL
208M00000X
Hospitalist Physician
Primary
036091808
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0222075
BLUE CROSS GROUP NUMBER
IL
01
036091808
STATE LICENSE
IL
05
036091808
IL
01
363149833
TAX IDENTIFICATION NUMBER
IL
01
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
02/06/2007
Last updated
01/30/2020
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