Ali, Mir M

Ali, Mir M is an individual health care provider with primary practice located at 17850 Kedzie Ave 3200, Hazel Crest IL 60429-2058. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ali, Mir M can be contacted via phone (708) 798-8112.

Contact Information

Primary practice address
17850 Kedzie Ave 3200 Hazel Crest IL 60429-2058
Fax: (708) 798-9016
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036103972 Illinois

Profile Details

NPI number 1407853435
LBN Legal business name Ali, Mir M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Jun 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407853435 NPPES
Illinois MEDICAID 036103972

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