Provider Demographics
NPI:1699981449
Name:M. DARWISH MEDICAL CENTER
Entity type:Organization
Organization Name:M. DARWISH MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:E
Authorized Official - Last Name:DARWISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-668-5530
Mailing Address - Street 1:511 THORNHILL DR
Mailing Address - Street 2:STE A
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2795
Mailing Address - Country:US
Mailing Address - Phone:630-668-5530
Mailing Address - Fax:630-668-5896
Practice Address - Street 1:511 THORNHILL DR
Practice Address - Street 2:STE A
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2795
Practice Address - Country:US
Practice Address - Phone:630-668-5530
Practice Address - Fax:630-668-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036047229208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002201176OtherBLUE CROSS BLUE SHIELD
IL036047229Medicaid
IL341910079OtherRAILROAD MEDICARE
IL1992715239OtherNPI
IL036047229Medicaid
IL0002201176OtherBLUE CROSS BLUE SHIELD