Healthcare Provider Details

I. General information

NPI: 1245307289
Provider Name (Legal Business Name): SYED J QUADRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 FLETCHER DR SUITE 305
ELGIN IL
60123-4703
US

IV. Provider business mailing address

750 FLETCHER DR SUITE 305
ELGIN IL
60123-4703
US

V. Phone/Fax

Practice location:
  • Phone: 847-742-3333
  • Fax: 847-742-9070
Mailing address:
  • Phone: 847-742-3333
  • Fax: 847-742-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36088009
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: