Provider Demographics
NPI:1114358017
Name:MARCON MEDICAL PARTNERS INC
Entity Type:Organization
Organization Name:MARCON MEDICAL PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAJJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-971-8991
Mailing Address - Street 1:1140 N MCLEAN BLVD
Mailing Address - Street 2:UNIT C
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1782
Mailing Address - Country:US
Mailing Address - Phone:224-558-5493
Mailing Address - Fax:
Practice Address - Street 1:1140 N MCLEAN BLVD
Practice Address - Street 2:UNIT C
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1782
Practice Address - Country:US
Practice Address - Phone:224-558-5493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117058207R00000X
IL085002516363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036117058OtherILLINOIS LICENSE