Provider Demographics
NPI:1346227295
Name:MUZAFFAR, KAMIL (MD)
Entity Type:Individual
Prefix:
First Name:KAMIL
Middle Name:
Last Name:MUZAFFAR
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 1:2160 S 1ST AVE
Mailing Address - Street 2:(9608 ROBERTS RD., HICKORY HILLS, IL. 60457)
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-233-5333
Mailing Address - Fax:708-233-5348
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:(9608 ROBERTS RD., HICKORY HILLS, IL. 60457)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-233-5333
Practice Address - Fax:708-233-5348
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36094467207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK01733OtherMEDICARE
IL36094467Medicaid
ILK01733OtherMEDICARE
IL36094467Medicaid