Provider Demographics
NPI:1316242928
Name:SYNCHRONY CHICAGO WEIGHT LOSS
Entity type:Organization
Organization Name:SYNCHRONY CHICAGO WEIGHT LOSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-990-2440
Mailing Address - Street 1:2425 W 22ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1245
Mailing Address - Country:US
Mailing Address - Phone:630-990-2440
Mailing Address - Fax:630-990-2441
Practice Address - Street 1:2425 W 22ND ST
Practice Address - Street 2:SUITE 201
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1245
Practice Address - Country:US
Practice Address - Phone:630-990-2440
Practice Address - Fax:630-990-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046816208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL336046816Medicaid
IL336046816Medicaid