Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 036.155890 | IL |
NPI | 1255825543 |
---|---|
Provider Name | Dr. Moiz Suhail |
First Address | Darien, IL 60561-4369 |
Second Address | Hazel Crest, IL 60429-2193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 27/09/2021 |