Individual
MOHAMMAD R. REZAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5645 W. ADDISON STREET, OUR LADY OF THE RESURRECTION HOSPITAL, CHICAGO, IL 60634
(773) 282-7000
Mailing address
5645 W ADDISON ST, CHICAGO, IL 60634-4403
(773) 794-7678
(773) 794-7694
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036061658
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061685
—
IL
Enumeration date
06/07/2006
Last updated
09/24/2013
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