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MOHAMMED KHALEELUDDIN MD NPI 1205976024


NPI Information

NPI: 1205976024
Provider Name: MOHAMMED KHALEELUDDIN, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1729 OAK PARK DRIVE
ROCKFORD, IL
ZIP 61107
Phone: (815) 395-0632
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Mohammed Khaleeluddin, MD is a family medicine in Rockford, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Mohammed Khaleeluddin, MD NPI is 1205976024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1729 OAK PARK DRIVE
ROCKFORD, IL
ZIP 61107-510
Phone: (815) 395-0632
Fax: (815) 395-0632

The enumeration date for this NPI number is 2/8/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036087482ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1202593MEDICARE ID-TYPE UNSPECIFIED
20004132023OTHERBLUE CROSS BLUE SHIELD
3F73716MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.