Mohammad a Razzaque MD,LTD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036089799 Issued in IL

Legal business name

MOHAMMAD A RAZZAQUE MD,LTD

Practice address

3228 W 95TH St
Evergreen Park, IL 60805-2314

Phone

(708) 425-4800

Fax

(708) 422-6534

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

Mohammad A Razzaque, M.DNPI 1184683849

Title

President

Phone

(708) 425-4800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mohammad A Razzaque MD,LTD Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Abdur Razzaque, M.D.

  • Internal Medicine Physician
  • Evergreen Park, IL
  • NPI 1184683849
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1659587954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052314",
            "fax_number": "708-422-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052314",
            "telephone_number": "708-425-4800",
            "fax_number": "708-422-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMMAD A RAZZAQUE MD,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "RAZZAQUE",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-425-4800",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036089799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00036664",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mohammad A Razzaque MD,LTD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriela Linnea Minard, DPT
• Mind Over Matter Psychiatric Home Healthcare, Inc.
• Tyler Mitchell, LPC
• Syed A Moeed, M.D.
• Mahmoud Mohamed, MD
• Alia Mohammad
• Nusaibah Mohsin
• Syed Mohsin, M.D.
• Wynnette J. Moneka, M.A.
• Patrick Montag

• Internal Medicine Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.