Provider Demographics
NPI:1710166475
Name:CEENA HEALTH PC
Entity Type:Organization
Organization Name:CEENA HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-724-9999
Mailing Address - Street 1:7516 S CASS AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561
Mailing Address - Country:US
Mailing Address - Phone:630-724-9999
Mailing Address - Fax:630-724-1078
Practice Address - Street 1:7516 S CASS AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561
Practice Address - Country:US
Practice Address - Phone:630-724-9999
Practice Address - Fax:630-724-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360477651207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02232210OtherBLUE CROSS BLUE SHIELD
D12856Medicare UPIN
L93797Medicare PIN