Healthcare Provider Details

I. General information

NPI: 1700580875
Provider Name (Legal Business Name): MUDASSIR SAYEED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 N HIGHLAND AVE STE 100
AURORA IL
60506-1459
US

IV. Provider business mailing address

1315 N HIGHLAND AVE STE 100
AURORA IL
60506-1459
US

V. Phone/Fax

Practice location:
  • Phone: 630-413-9119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.180018
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: