Individual
MASUM KIDIWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8841 MAJOR AVE, MORTON GROVE, IL 60053-2531
(847) 899-2544
Mailing address
8841 MAJOR AVE, MORTON GROVE, IL 60053-2531
(847) 899-2544
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
041476223
IL
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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