Provider Demographics
NPI:1356427256
Name:HUSSAIN, MOHAMMED TAJAMMUL (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:TAJAMMUL
Last Name:HUSSAIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 IROQUOIS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8571
Mailing Address - Country:US
Mailing Address - Phone:630-906-3700
Mailing Address - Fax:630-906-0730
Practice Address - Street 1:1280 IROQUOIS AVE STE 300
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8571
Practice Address - Country:US
Practice Address - Phone:630-906-3700
Practice Address - Fax:630-906-0730
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-084973282N00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No282N00000XHospitalsGeneral Acute Care Hospital