Individual
MIRA ADLY MAHMOUD AYOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 S PRAIRIE AVE APT 1202, CHICAGO, IL 60605-3648
(412) 427-1582
Mailing address
1211 S PRAIRIE AVE APT 1202, CHICAGO, IL 60605-3648
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
036-161974
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036-161974
IL
Other
Enumeration date
06/23/2020
Last updated
07/16/2025
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