Provider Demographics
NPI:1922098524
Name:AFIFI, MOHAMED S (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:S
Last Name:AFIFI
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 1:251 E HURON ST
Mailing Address - Street 2:FEINBURG 8-336
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-695-9797
Mailing Address - Fax:312-926-8341
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-695-9797
Practice Address - Fax:312-695-8341
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036107813207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036107813Medicaid
IL036107813Medicaid
ILK21420Medicare PIN