Provider Demographics
NPI:1437258340
Name:MUNSHI, HIDAYATULLAH G (MD)
Entity Type:Individual
Prefix:DR
First Name:HIDAYATULLAH
Middle Name:G
Last Name:MUNSHI
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 1:303 E SUPERIOR ST
Mailing Address - Street 2:LURIE BUILDING, ROOM 3-117
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3015
Mailing Address - Country:US
Mailing Address - Phone:312-503-2301
Mailing Address - Fax:312-503-0386
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:21-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-908-5284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology