Healthcare Provider Details

I. General information

NPI: 1356760995
Provider Name (Legal Business Name): TALAL AKHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 N. CALIFORNIA AVE. DEPARTMENT OF RADIOLOGY
CHICAGO IL
60625-3661
US

IV. Provider business mailing address

2650 RIDGE AVE. 1223
EVANSTON IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 773-989-3814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036153416
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number036153416
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: