Organization
ALI RIAZI M.D. SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI RIAZI (OWNER)
(708) 447-1220
Entity
Organization
Contact information
Practice address
1431NORTH CLAIRMONT, CHICAGO, IL 60622
(708) 447-1220
Mailing address
725 CHESTNUT AVE, WILMETTE, IL 60091-1741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36046938
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021604495
BLUE CROSS
IL
Enumeration date
08/27/2007
Last updated
08/27/2007
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