Provider Demographics
NPI:1750590147
Name:MATARIA, MOHAMMAD RASMI (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:RASMI
Last Name:MATARIA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:713 SAINT JOSEPHS DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2570
Mailing Address - Country:US
Mailing Address - Phone:708-570-4661
Mailing Address - Fax:630-655-3362
Practice Address - Street 1:17495 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7581
Practice Address - Country:US
Practice Address - Phone:630-873-8889
Practice Address - Fax:630-456-7138
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2016-11-22
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Provider Licenses
StateLicense IDTaxonomies
IL036117287207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA27675551Medicare PIN