Healthcare Provider Details

I. General information

NPI: 1669932000
Provider Name (Legal Business Name): ROHAIL RASHID KAZI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N WEBER RD
BOLINGBROOK IL
60490-1504
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-790-1221
  • Fax: 630-967-0047
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number59397
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036-178791
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: