Provider Demographics
NPI:1386212199
Name:MOHIUDDIN, HIBA (MD)
Entity Type:Individual
Prefix:
First Name:HIBA
Middle Name:
Last Name:MOHIUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5897
Mailing Address - Country:US
Mailing Address - Phone:630-978-4850
Mailing Address - Fax:630-978-6865
Practice Address - Street 1:2020 OGDEN AVE STE 330
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5897
Practice Address - Country:US
Practice Address - Phone:630-978-4850
Practice Address - Fax:630-978-6865
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.077703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine