| Mohammad a Razzaque Md,ltd | |
|
3228 W 95th St Evergreen Park IL 60805-2314 | |
| (708) 425-4800 | |
| (708) 422-6534 |
| Full Name | Mohammad a Razzaque Md,ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 3228 W 95th St, Evergreen Park, Illinois |
| Authorized Official Name and Position | Mohammad a Razzaque (PRESIDENT) |
| Authorized Official Contact | 7084254800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad a Razzaque Md,ltd 3228 W 95th St Evergreen Park IL 60805-2314 | Mohammad a Razzaque Md,ltd 3228 W 95th St Evergreen Park IL 60805-2314 Ph: (708) 425-4800 |
| NPI Number | 1659587954 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 8224064142 |
|---|---|
| Medicare Enrollment ID | O20050712001056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659587954 | NPI | - | NPPES |
| P00036664 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036089799 (Illinois) | Primary |
| Provider Name | Mohammad a Razzaque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184683849 PECOS PAC ID: 4183650005 Enrollment ID: I20050721000500 |
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