Provider Demographics
NPI:1164818449
Name:SHEIKH, MOHAMMAD TAHA MUSTAF TAHA MUSTAFA (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD TAHA MUSTAF
Middle Name:TAHA MUSTAFA
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 NORTH NORTHWEST HIGHWAY SUITE 107
Mailing Address - Street 2:L.M. PRASAD, MD, SC
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-759-1110
Mailing Address - Fax:
Practice Address - Street 1:1550 NORTH NORTHWEST HIGHWAY SUITE 107
Practice Address - Street 2:L.M. PRASAD, MD, SC
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-759-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2015-11-25
Deactivation Date:2015-11-17
Deactivation Code:
Reactivation Date:2015-11-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program