Provider Demographics
NPI:1760867568
Name:HUSAIN, MUHAMMAD RIZWAN (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD RIZWAN
Middle Name:
Last Name:HUSAIN
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 1:4600 N CLARENDON AVE
Mailing Address - Street 2:APT 908
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5710
Mailing Address - Country:US
Mailing Address - Phone:773-437-0261
Mailing Address - Fax:
Practice Address - Street 1:912 S WOOD ST
Practice Address - Street 2:NPI BUILDING, ROOM 174N,M/C 796
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4300
Practice Address - Country:US
Practice Address - Phone:312-996-6496
Practice Address - Fax:312-996-4169
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.067046390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program