Provider Demographics
NPI:1013968163
Name:SHEIKH, MOHSIN A (MD)
Entity Type:Individual
Prefix:
First Name:MOHSIN
Middle Name:A
Last Name:SHEIKH
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 1:3216 WHITE EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4651
Mailing Address - Country:US
Mailing Address - Phone:219-789-2751
Mailing Address - Fax:
Practice Address - Street 1:2088 OGDEN AVE STE 210
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4385
Practice Address - Country:US
Practice Address - Phone:630-898-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112483202K00000X
IL036-1124832085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDC4196OtherGROUP MEDICARE RAILROAD PTAN
IL789510OtherGROUP MEDICARE PTAN
IL789511OtherGROUP MEDICARE PTAN
IN250520OtherGROUP MEDICARE PTAN
H39965Medicare UPIN
ILT01750Medicare PIN
IL789511OtherGROUP MEDICARE PTAN
IN250520OtherGROUP MEDICARE PTAN
IL789510OtherGROUP MEDICARE PTAN