Individual
MAHMOUD MIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
820 S WOOD ST, CSN 515, CHICAGO, IL 60612
(847) 373-3359
Mailing address
5906 N KENMORE AVE APT B-7, CHICAGO, IL 60660-5109
(847) 373-3359
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
125.069853
IL
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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