Individual
MR. MOHAMMAD I MOHIUDDIN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA,CSA
Contact information
Practice address
208 WESTMORE MEYERS RD, LOMBARD, IL 60148-3041
(630) 935-2118
Mailing address
208 WESTMORE MEYERS RD, LOMBARD, IL 60148-3041
(630) 935-2118
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238.000180
IL
363AS0400X
Surgical Physician Assistant
238.000180
IL
Other
Enumeration date
07/26/2012
Last updated
10/15/2015
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