Provider Demographics
NPI:1558381772
Name:MUNIR, RAKHSHANDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAKHSHANDA
Middle Name:M
Last Name:MUNIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RAKHSHANDA
Other - Middle Name:M
Other - Last Name:MUNIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4438 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3743
Mailing Address - Country:US
Mailing Address - Phone:773-794-2100
Mailing Address - Fax:773-794-2492
Practice Address - Street 1:4438 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3743
Practice Address - Country:US
Practice Address - Phone:773-794-2100
Practice Address - Fax:773-794-2492
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094551207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336055611OtherSUBSTANCE CONTROLLED
IL036094551Medicaid
IL036094551Medicaid
IL536800Medicare ID - Type Unspecified
BM5310230OtherDEA
IL336055611OtherSUBSTANCE CONTROLLED