Basic Information
| Provider Information | |||||||||
| NPI: | 1215978473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RASHEED | ||||||||
| FirstName: | MEHMOODUR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 611 W. PARK ST. | ||||||||
| Address2: | BWPC | ||||||||
| City: | URBANA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 618012500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173836792 | ||||||||
| FaxNumber: | 2173834752 | ||||||||
| Practice Location | |||||||||
| Address1: | 1813 W KIRBY AVE | ||||||||
| Address2: | |||||||||
| City: | CHAMPAIGN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 618215410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173833131 | ||||||||
| FaxNumber: | 2173833439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 05/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-08-2253 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | 35-08-2253 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 036127013 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | P00072833 | 01 | RR MEDICARE | OTHER | 001714149 | 01 | MOUNTAIN STATE BCBS | OTHER | 1215978473 | 01 | NPI | OTHER | 3004892000 | 05 | WV | MEDICAID | 000000309233 | 01 | ANTHEM BCBS | OTHER | 000000185219 | 01 | OH | UNISON MEDICAID | OTHER | 2500181 | 01 | OH | MOLINA MEDICAID | OTHER | 310917085148 | 01 | OH | CARESOURCE MEDICAID | OTHER |