Individual
MOHAMMAD AL-KHUDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6201 W 95TH ST, OAK LAWN, IL 60453-2701
(708) 636-9393
(708) 636-2022
Mailing address
6201 W 95TH ST, OAK LAWN, IL 60453-2701
(708) 636-9393
(708) 636-2022
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036103747
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001633597
BCBS PROVIDER ID
IL
05
—
036103747
—
IL
01
—
120602
ADVOCATE HLTH PARTNERS ID
IL
01
—
125181500
OWCP PROVIDER ID
IL
01
—
56233132500
ADVOCATE HLTH CENTERS ID
IL
01
—
P00053534
RAILROAD MEDICARE
IL
Enumeration date
09/15/2005
Last updated
11/25/2024
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