Provider Demographics
NPI:1851384663
Name:DIA, MUHYALDEEN (MD,FACC)
Entity type:Individual
Prefix:DR
First Name:MUHYALDEEN
Middle Name:
Last Name:DIA
Suffix:
Gender:
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10837 S CICERO AVE STE 200
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6459
Practice Address - Country:US
Practice Address - Phone:708-636-7575
Practice Address - Fax:708-636-6193
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-088800207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL060053842OtherPALMETTO GBA INDIVIDUAL #
ILCI8250OtherPALMETTO GBA GROUP #
IL21622931OtherBCBS GROUP #
IL036088800Medicaid
ILCI8250OtherPALMETTO GBA GROUP #
IL21622931OtherBCBS GROUP #
IL526200Medicare ID - Type UnspecifiedMEDICARE GROUP #
ILL68673Medicare ID - Type UnspecifiedMEDICARE INDIV PROV ID #