Provider Demographics
NPI:1740454958
Name:AKHTAR MD SC
Entity type:Organization
Organization Name:AKHTAR MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOYEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-784-2101
Mailing Address - Street 1:5140 N CALIFORNIA AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3645
Mailing Address - Country:US
Mailing Address - Phone:773-784-2101
Mailing Address - Fax:773-784-0771
Practice Address - Street 1:5140 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3645
Practice Address - Country:US
Practice Address - Phone:773-784-2101
Practice Address - Fax:773-784-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082907282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036082907Medicare PIN