Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Koosha Medical Center P C

Organization Family Medicine Physician · NPI 1164711644

Koosha Medical Center P C is a Family Medicine Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011

Practice location Address checks out

4438 N Milwaukee Ave
Chicago, IL 60630-3743
Phone: (773) 794-2100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0360856071 (IL)

Record details

NPI number1164711644
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ebrahim Ghodsizadeh — Owner · (773) 794-2100
NPI enumeratedApril 5, 2011
Last updated in NPPESMarch 7, 2023
Mailing address4438 N Milwaukee Ave, Chicago, IL 60630-3743

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