Organization
JFA MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED J ALI M.D. (OWNER)
(773) 533-1621
Entity
Organization
Contact information
Practice address
732 S PULASKI RD, CHICAGO, IL 60624-4058
(773) 533-1621
Mailing address
211 SOMERSET RD, WILLOWBROOK, IL 60527-5430
(630) 455-5531
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036062868
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062868
—
IL
Enumeration date
03/11/2010
Last updated
03/11/2010
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