Healthcare Provider Details

I. General information

NPI: 1508954678
Provider Name (Legal Business Name): NADIA HAIDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 N LAKE SHORE DR
CHICAGO IL
60611-4546
US

IV. Provider business mailing address

6438 SAINT JAMES CT
BURR RIDGE IL
60527-5773
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-6868
  • Fax:
Mailing address:
  • Phone: 630-640-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number49231-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number036120743
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036120743
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: