Individual
MOHAMMED O PERACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 E WEST RD, CALUMET CITY, IL 60409-5415
(708) 891-3330
Mailing address
1700 E WEST RD, CALUMET CITY, IL 60409-5415
(708) 891-3330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01059313A
IN
207W00000X
Ophthalmology Physician
Primary
036123530
IL
207W00000X
Ophthalmology Physician
45488
IA
207WX0107X
Retina Specialist (Ophthalmology) Physician
45488
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123530
—
IL
05
—
200423140
—
IN
Enumeration date
08/10/2005
Last updated
01/29/2019
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