Provider Demographics
NPI:1235522525
Name:MAASAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:MAASAL MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAASAL
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:SHAHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-654-1077
Mailing Address - Street 1:3462 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5117
Mailing Address - Country:US
Mailing Address - Phone:773-654-1077
Mailing Address - Fax:773-942-6847
Practice Address - Street 1:3462 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5117
Practice Address - Country:US
Practice Address - Phone:773-654-1077
Practice Address - Fax:773-942-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036126749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty