Healthcare Provider Details

I. General information

NPI: 1477817278
Provider Name (Legal Business Name): ADNAN QADIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S RANDALL RD STE 210
ALGONQUIN IL
60102-5937
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 224-783-4365
  • Fax: 224-783-4356
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036136379
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: