Organization
GHANI MEDICAL CENTER, MD SC
Active
Other names
Allergy & Immunology Center
Organization subpart
No
Provider details
NPI number
Authorized official
NINA THOMPSON (OFFICE MANAGER)
(708) 344-3550
Entity
Organization
Contact information
Practice address
10001 W ROOSEVELT RD, SUITE 304, WESTCHESTER, IL 60154-2664
(708) 344-3550
(708) 344-6577
Mailing address
10001 W ROOSEVELT RD, SUITE 304, WESTCHESTER, IL 60154-2664
(708) 344-3550
(708) 344-6577
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
036-050567
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
085-001419
IL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
085-001462
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617646
BC/BS
IL
05
—
6015401
—
IL
Enumeration date
03/20/2009
Last updated
03/20/2009
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