Provider Demographics
NPI:1134643364
Name:MAFRAJI, MUSTAFA ANWER JASIM (MBBS)
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:ANWER JASIM
Last Name:MAFRAJI
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Gender:M
Credentials:MBBS
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Mailing Address - Street 1:1653 W CONGRESS PKWY
Mailing Address - Street 2:DEPT OF DIAGNOSTIC RADIOLOGY JELKE BUILDING 181
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3833
Mailing Address - Country:US
Mailing Address - Phone:312-942-4184
Mailing Address - Fax:312-942-7244
Practice Address - Street 1:1653 W CONGRESS PKWY DEPT OF
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-942-4184
Practice Address - Fax:312-942-7244
Is Sole Proprietor?:No
Enumeration Date:2017-07-30
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
IL1250697982085D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging