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NPI Code Detail

MEDICARE: DR. NUSRATH AKHTAR M.D.

MEDICARE:  DR. NUSRATH  AKHTAR  M.D.
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
1208000000XPediatrics Physician036076575IL
2208000000XPediatrics Physician036-076575IL

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 : 1851316889
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NUSRATH AKHTAR M.D.
Provider Business Mailing Address
First Line : 6840 S. MAIN STREET
Second Line : SUITE 201
City : DOWNERS GROVE
State : IL
Zip : 60516-3493
Country : US
Telephone Number : 630-852-4551
Fax Number : 630-852-0131
Provider Business Practice Location Address
First Line : 6840 S. MAIN STREET
Second Line : SUITE 201
City : DOWNERS GROVE
State : IL
Zip : 60516-3493
Country : US
Telephone Number : 630-852-4551
Fax Number : 630-852-0131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 11/17/2009

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