MR. MUNIB SAID MAFAZY NURSE PRACTIONER NPI 1588859169

NPI Information

NPI: 1588859169
Provider Name: MR. MUNIB SAID MAFAZY, NURSE PRACTIONER
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: CARLE WEST PHYSICIAN GROUP INC

PECOS Registration: Yes

Address:
2204 EASTLAND DR
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 661-6900
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MR. Munib Said Mafazy, NURSE PRACTIONER is a family nurse practitioner in Bloomington, IL with 17 years of experience. MR. Munib Said Mafazy, NURSE PRACTIONER NPI is 1588859169. 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:

2204 EASTLAND DR
BLOOMINGTON, IL
ZIP 61704-566
Phone: (309) 661-6900

The NPI 1588859169 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/7/2007 and was last updated on 6/28/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209.006784	ILLINOIS	Yes

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

NPI Synchronization or Removal

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