Healthcare Provider Details

I. General information

NPI: 1710328703
Provider Name (Legal Business Name): ALI SYED ANWAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2013
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 LARKIN AVE STE 202
ELGIN IL
60123-5899
US

IV. Provider business mailing address

660 S EUCLID AVE CAMPUS BOX 8134
ST. LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 847-697-2400
  • Fax: 847-697-2438
Mailing address:
  • Phone: 314-747-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036145999
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036145999
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: