Provider Demographics
NPI:1194739268
Name:GHANI, MUHAMMAD T K (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:T K
Last Name:GHANI
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 1:10001 W ROOSEVELT RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2664
Mailing Address - Country:US
Mailing Address - Phone:708-344-3550
Mailing Address - Fax:708-344-6577
Practice Address - Street 1:10031 W ROOSEVELT RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2669
Practice Address - Country:US
Practice Address - Phone:708-344-3550
Practice Address - Fax:708-344-3550
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036050567207K00000X
IL036-050567207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036050567Medicaid
IL036-0505567Medicaid
ILD13901Medicare UPIN