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

Mamoor Shahid Latef

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1255890331

Mamoor Shahid Latef is a Pathology in Maywood, Illinois. Qualified in 2015, 11 years ago. Practices with Ohio Valley Pathology Associates Inc, a 3-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
11
Licensed in
IL
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

2160 S 1st Ave Bldg 107
Maywood, IL 60153-3328
Phone: (708) 216-9100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 036167999 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1255890331
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 18, 2019
Last updated in NPPESSeptember 23, 2024
Certification dateSeptember 23, 2024
Mailing address2160 S 1st Ave Bldg 107, Maywood, IL 60153-3328

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Ohio Valley Pathology Associates Inc. — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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