1790304657 NPI number — MISS MEHR AMER MAJEED M.D.

Table of content: MISS MEHR AMER MAJEED M.D. (NPI 1790304657)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790304657 NPI number — MISS MEHR AMER MAJEED M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAJEED
Provider First Name:
MEHR
Provider Middle Name:
AMER
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790304657
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ADVOCATE INTERNAL MEDICINE CLINIC, ADVOCATE ILLINOIS MA
Provider Second Line Business Mailing Address:
836 WEST WELLINGTON AVENUE
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-296-5424
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 S GRAND BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63104-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-257-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  2023026684 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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