Healthcare Provider Details

I. General information

NPI: 1801968953
Provider Name (Legal Business Name): MUSSARAT ARSHAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 W ALGONQUIN RD SUITE A
ALGONQUIN IL
60102-9403
US

IV. Provider business mailing address

4 SHEARWATER CT
HAWTHORN WOODS IL
60047-7523
US

V. Phone/Fax

Practice location:
  • Phone: 847-658-4403
  • Fax:
Mailing address:
  • Phone: 847-540-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number336053897
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier036092453
Identifier TypeMEDICAID
Identifier StateIL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: