Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036-088800 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036-088800 | IL |
NPI | 1851384663 |
---|---|
Provider Name | Dr. Muhyaldeen Dia |
First Address | Oak Lawn, IL 60453-6459 |
Second Address | Oak Lawn, IL 60453-6459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036088800 | (05) | IL |
060053842 | PALMETTO GBA INDIVIDUAL # (01) | IL |
21622931 | BCBS GROUP # (01) | IL |
CI8250 | PALMETTO GBA GROUP # (01) | IL |
G90731 | (02) | IL |