Provider Demographics
NPI:1720348774
Name:ADDISON MEDICAL SQUARE, LTD.
Entity Type:Organization
Organization Name:ADDISON MEDICAL SQUARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-543-5454
Mailing Address - Street 1:276 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3767
Mailing Address - Country:US
Mailing Address - Phone:630-543-5454
Mailing Address - Fax:630-543-5471
Practice Address - Street 1:276 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3767
Practice Address - Country:US
Practice Address - Phone:630-543-5454
Practice Address - Fax:630-543-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067984207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty