Provider Demographics
NPI:1629137492
Name:ENGLEWOOD MANAGEMENT HEALTH, S.C.
Entity Type:Organization
Organization Name:ENGLEWOOD MANAGEMENT HEALTH, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MUNAVVAR
Authorized Official - Middle Name:
Authorized Official - Last Name:IZHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-651-1225
Mailing Address - Street 1:6508 S HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-2616
Mailing Address - Country:US
Mailing Address - Phone:773-651-1225
Mailing Address - Fax:773-651-1229
Practice Address - Street 1:6508 S HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-2616
Practice Address - Country:US
Practice Address - Phone:773-651-1225
Practice Address - Fax:773-651-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty