Provider Demographics
NPI:1295736726
Name:KATERJI, MOHAMED AMMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:AMMAR
Last Name:KATERJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M
Other - Middle Name:AMMAR
Other - Last Name:KATERJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1220 IROQUOIS AVE #140
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563
Mailing Address - Country:US
Mailing Address - Phone:630-778-8004
Mailing Address - Fax:630-946-6634
Practice Address - Street 1:1220 IROQUOIS AVE #140
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-778-8004
Practice Address - Fax:630-946-6634
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-078050208000000X, 2084N0400X
IL0360780502084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-078050-5Medicaid
IL036078050Medicaid
F64773Medicare UPIN
IL036078050Medicaid