Provider Demographics
NPI:1093325763
Name:AL KHURIDAH, ZAHRA MOSTAFA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ZAHRA
Middle Name:MOSTAFA
Last Name:AL KHURIDAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 SOUTH WOOD STREET - UNIVERSITY OF ILLINOIS AT CHICA
Mailing Address - Street 2:SUITE 100, MK 675, OFFICE OF GME
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-2933
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ILLINOIS HOSPITAL
Practice Address - Street 2:1740 W. TAYLOR ST.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.077045390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program