Healthcare Provider Details

I. General information

NPI: 1033057377
Provider Name (Legal Business Name): SYED KAZMI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALI KAZMI

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

656 BURDETTE AVE
GLENDALE HEIGHTS IL
60139-3373
US

IV. Provider business mailing address

656 BURDETTE AVE
GLENDALE HEIGHTS IL
60139-3373
US

V. Phone/Fax

Practice location:
  • Phone: 224-704-3866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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: