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NPI Code Detail

MEDICARE: SAJJAD H HABIB MD

MEDICARE: SAJJAD H HABIB MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician01061182IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528019619
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAJJAD H HABIB MD
Provider Business Mailing Address
First Line : 120 W 22ND ST STE 200
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1563
Country : US
Telephone Number : 630-573-5000
Fax Number : 630-491-5472
Provider Business Practice Location Address
First Line : 7836 W JEFFERSON BLVD
Second Line : SUITE 101
City : FORT WAYNE
State : IN
Zip : 46804-4165
Country : US
Telephone Number : 260-494-3484
Fax Number : 260-969-0188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 11/10/2022

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