MEDICARE: RIAZ A. AKHTAR

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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000900130	OTHER	IL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	060016608	OTHER	IL	RAILROAD

General Provider Information

NPI Number	:	1902072812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIAZ A. AKHTAR

Provider Business Mailing Address
First Line	:	910 S GROVE AVE
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60304-1904
Country	:	US
Telephone Number	:	170-838-6811
Fax Number	:	163-060-0467

Provider Business Practice Location Address
First Line	:	1 SOUTH 085 SUMMIT AVENUE
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-3978
Country	:	US
Telephone Number	:	630-629-6700
Fax Number	:	630-600-4677

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RIAZ A. AKHTAR
Credential	:	M.D.,F.A.C.C.
Telephone Number	:	17083868118

Provider Enumeration Date	:	05/01/2008
Last Update Date	:	05/01/2008

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