Individual
MOUHAMMAD E SOUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3452 GROVE AVE, SUITE 202, BERWYN, IL 60402-3636
(708) 484-0621
(708) 484-0250
Mailing address
3452 GROVE AVE, SUITE 202, BERWYN, IL 60402-3636
(708) 484-0621
(708) 484-0250
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-049688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619787
BCBSIL GROUP NUMBER
—
05
—
036049688
—
IL
Enumeration date
10/20/2005
Last updated
03/09/2011
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