Provider Demographics
NPI:1407185499
Name:MOHAMMAD, SULAIMAN (MD)
Entity Type:Individual
Prefix:
First Name:SULAIMAN
Middle Name:
Last Name:MOHAMMAD
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 1:15 TOWER CT STE 210
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3355
Mailing Address - Country:US
Mailing Address - Phone:847-599-0715
Mailing Address - Fax:847-599-0766
Practice Address - Street 1:15 TOWER CT STE 210
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3355
Practice Address - Country:US
Practice Address - Phone:847-599-0715
Practice Address - Fax:847-599-0766
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010689502084N0400X
IL036-1288912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036128891OtherSTATE LICENSE