Organization
ILLINOIS MEDICAL CARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHER AL-KOUBAYTARI MD (PRESIDENT)
(773) 931-8082
Entity
Organization
Contact information
Practice address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 931-8082
(888) 847-9526
Mailing address
1721 GREENDALE AVE, PARK RIDGE, IL 60068-1926
(773) 931-8082
(888) 847-9526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036094781
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094781
—
IL
Enumeration date
03/19/2007
Last updated
01/30/2018
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