Healthcare Provider Details

I. General information

NPI: 1215183140
Provider Name (Legal Business Name): ABRAR ALI HUSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S WACKER DR FL 31
CHICAGO IL
60606-5877
US

IV. Provider business mailing address

PO BOX 211699
EAGAN MN
55121-3699
US

V. Phone/Fax

Practice location:
  • Phone: 866-849-0692
  • Fax: 888-797-3888
Mailing address:
  • Phone: 866-849-0692
  • Fax: 888-797-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125054451
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: