| Mohammad Khader, | |
|
7124 W 83rd St Unit C, Bridgeview, IL 60455-4034 | |
| (708) 424-0909 | |
| (708) 424-1715 |
| Full Name | Mohammad Khader |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 7124 W 83rd St Unit C, Bridgeview, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093437105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209025973 (Illinois) | Primary |
| Entity Name | Skyline Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568704443 PECOS PAC ID: 9133367931 Enrollment ID: O20130606000709 |
| Entity Name | Urgiclinic Urgent Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982301685 PECOS PAC ID: 0143688069 Enrollment ID: O20230623002479 |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad Khader, 9015 W 151st St Unit A, Orland Park, IL 60462-3201 Ph: (708) 737-9724 | Mohammad Khader, 7124 W 83rd St Unit C, Bridgeview, IL 60455-4034 Ph: (708) 424-0909 |
Yesenia Sianez, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7124 W 83rd St Unit C, Bridgeview, IL 60455 Phone: 708-788-5088 Fax: 708-575-7177 | |
Leonor Elizabeth Delgadillo, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7020 W 79th St, Bridgeview, IL 60455 Phone: 708-599-8200 Fax: 708-599-8306 |