Healthcare Provider Details

I. General information

NPI: 1306584669
Provider Name (Legal Business Name): ASBAH RAHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 S WOOD ST STE 888
CHICAGO IL
60612-7300
US

IV. Provider business mailing address

2109 REGENT PL APT 7
BROOKLYN NY
11226-8547
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-6732
  • Fax:
Mailing address:
  • Phone: 718-925-1590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number125.085123
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: