MEDICARE: DR. SYED HUSAIN 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
1	207P00000X	Emergency Medicine Physician	036-105041	IL
2	207R00000X	Internal Medicine Physician	036105041	IL
3	208M00000X	Hospitalist Physician	036105041	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1619998119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYED HUSAIN MD

Provider Business Mailing Address
First Line	:	345 W FULLERTON PKWY
Second Line	:	SUITE 2903
City	:	CHICAGO
State	:	IL
Zip	:	60614-2856
Country	:	US
Telephone Number	:	773-209-6808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 N CLYBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-1737
Country	:	US
Telephone Number	:	312-988-7300
Fax Number	:	312-988-7303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	04/17/2018

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