Individual
MOHAMMED J MOHIUDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2202 HARLEM ROAD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM ROAD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.142717
IL
207L00000X
Anesthesiology Physician
43730020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12952
DEANCARE HMO
WI
05
—
34131900
—
WI
Enumeration date
10/13/2005
Last updated
07/28/2025
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