Provider Demographics
NPI:1205028578
Name:IMRAN, MEHNAZ (MD)
Entity type:Individual
Prefix:DR
First Name:MEHNAZ
Middle Name:
Last Name:IMRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MEHNAZ
Other - Middle Name:
Other - Last Name:FATIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:4201 W MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8409
Practice Address - Country:US
Practice Address - Phone:815-759-4323
Practice Address - Fax:815-759-4948
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118530207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9932317OtherBCBS IL
IL036118530Medicaid
IL9932317OtherBCBS IL