Shamshuddin, Mohammad
Shamshuddin, Mohammad is an individual health care provider with primary practice located at 6703 159Th St Suite 103, Tinley Park IL 60477-1781. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Shamshuddin, Mohammad can be contacted via phone (708) 342-3000.Contact Information
Primary practice address
6703 159Th St Suite 103
Tinley Park IL 60477-1781
Phone: (708) 342-3000
Fax: (708) 342-3060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036091936 | Illinois |
Profile Details
| NPI number | 1801896261 |
|---|---|
| LBN Legal business name | Shamshuddin, Mohammad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Dec 19th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801896261 | NPPES |
| Illinois | MEDICAID | 036091936 | |
| Illinois | Other | 231199006 | |
| Illinois | Other | P00760031 |
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