Mohammed Yahya Mirza, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125084603 Issued in IL

Practice address

9555 S 52ND Ave
Oak Lawn, IL 60453-3054

Phone

(708) 422-5700

Fax

(708) 422-8225

NPI assigned

Apr 3, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mohammed.mirza.1@20867.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1245082205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 N YORK ST APT 121",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261248",
            "telephone_number": "630-418-7077",
            "fax_number": "630-418-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 S 52ND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533054",
            "telephone_number": "708-422-5700",
            "fax_number": "708-422-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "MOHAMMED",
        "middle_name": "YAHYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125084603",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Minhas, M.D.
• Minis Inc
• Julie Anne Minser, RN, MSN, AGNP-BC
• Priscila Audrey Miori
• Jean Mirabella, PH.D.
• Nureain Mirza, MD
• Kelly Misakian, FNP
• Seetal Mishra, M.D.
• Jonathan Miskevics, LPC
• Chintan Dhiren Mistry, MD

• Family Medicine Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.