Kizilbash, Mohammad Ali

Kizilbash, Mohammad Ali is an individual health care provider with primary practice located at 4309 W Medical Center Dr Ste A200 , Mchenry IL 60050. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Kizilbash, Mohammad Ali can be contacted via phone (815) 759-8070.

Contact Information

Primary practice address
4309 W Medical Center Dr Ste A200 Mchenry IL 60050
Phone: (815) 759-8070
Fax: (815) 759-4931
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 2009030104 Missouri
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036-111516 Illinois

Profile Details

NPI number 1114162948
LBN Legal business name Kizilbash, Mohammad Ali
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2008
Last updated Oct 19th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114162948 NPPES
Illinois Other 036111516 STATE LICENSE

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