Individual
DR. MUFADAL AMMAR MOOSABHOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5721 S MARYLAND AVE, K-155, CHICAGO, IL 60637-1425
(773) 702-6435
Mailing address
205 68TH ST, DARIEN, IL 60561-3920
(708) 369-9695
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125056396
IL
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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