Provider Demographics
NPI:1831249200
Name:ALINIAZEE, MATEEN K (MD)
Entity type:Individual
Prefix:DR
First Name:MATEEN
Middle Name:K
Last Name:ALINIAZEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2821
Mailing Address - Country:US
Mailing Address - Phone:630-833-9621
Mailing Address - Fax:630-833-9465
Practice Address - Street 1:152 N ADDISON AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-833-9621
Practice Address - Fax:630-833-9465
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036133256207W00000X
CAC52071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C520710Medicaid
CA00C520710Medicaid
CAWC52071AMedicare ID - Type UnspecifiedSAN LUIS OBISPO
CAWC52071CMedicare ID - Type UnspecifiedCAMBRIA
CA00C520710Medicaid
CAWC52071BMedicare ID - Type UnspecifiedARROYO GRANDE
CAWC52071DMedicare ID - Type UnspecifiedTEMPLETON