Healthcare Provider Details

I. General information

NPI: 1629272257
Provider Name (Legal Business Name): NADIA SULTANA HUSSAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S DAMEN AVE
CHICAGO IL
60612-3728
US

IV. Provider business mailing address

820 S DAMEN AVE
CHICAGO IL
60612-3728
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-8700
  • Fax:
Mailing address:
  • Phone: 312-569-6126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036117354
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036117354
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number036117354
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: