Healthcare Provider Details

I. General information

NPI: 1972815033
Provider Name (Legal Business Name): MUNEEB QADRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 REMINGTON BLVD STE 100
BOLINGBROOK IL
60440-5894
US

IV. Provider business mailing address

329 REMINGTON BLVD STE 100
BOLINGBROOK IL
60440-5894
US

V. Phone/Fax

Practice location:
  • Phone: 630-312-6550
  • Fax: 630-312-6551
Mailing address:
  • Phone: 630-312-6550
  • Fax: 630-312-6551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.131348
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: