Provider Demographics
NPI:1366702284
Name:LODHI, MAHAM W (MD)
Entity type:Individual
Prefix:DR
First Name:MAHAM
Middle Name:W
Last Name:LODHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1725 W HARRISON ST STE 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3988
Mailing Address - Country:US
Mailing Address - Phone:312-942-5861
Mailing Address - Fax:312-942-7394
Practice Address - Street 1:1725 W HARRISON ST STE 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-942-5861
Practice Address - Fax:312-942-7394
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.137730207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology