Provider Demographics
NPI:1295000677
Name:NAJEEB, SYED MOAZZAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:MOAZZAM
Last Name:NAJEEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:695 N KELLOGG ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2807
Mailing Address - Country:US
Mailing Address - Phone:309-343-7195
Mailing Address - Fax:309-343-2074
Practice Address - Street 1:695 N KELLOGG ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2807
Practice Address - Country:US
Practice Address - Phone:309-343-7195
Practice Address - Fax:309-343-2074
Is Sole Proprietor?:No
Enumeration Date:2012-03-18
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136930208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400274342Medicare PIN