Provider Demographics
NPI:1568415065
Name:MOHIUDDIN, MAJID M (MD)
Entity Type:Individual
Prefix:DR
First Name:MAJID
Middle Name:M
Last Name:MOHIUDDIN
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 1:700 COMMERCE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1546
Mailing Address - Country:US
Mailing Address - Phone:847-698-0600
Mailing Address - Fax:847-698-0601
Practice Address - Street 1:1700 LUTHER LN
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1270
Practice Address - Country:US
Practice Address - Phone:847-723-8030
Practice Address - Fax:847-723-1596
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD645702085R0001X
IL0361304912085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036130491Medicaid
MDD64570OtherPHYSICIAN LICENSE
MD410857400Medicaid
IL778401OtherMEDICARE PROVIDER NUMBER
IL558620OtherMEDICARE PROVIDER NUMBER
MDI64270Medicare UPIN
MDO347Medicare PIN
IL778401OtherMEDICARE PROVIDER NUMBER
MDP00413812Medicare PIN