Healthcare Provider Details

I. General information

NPI: 1659544252
Provider Name (Legal Business Name): ABDUL R SAFADI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MADISON ST STE 207
JOLIET IL
60435-6654
US

IV. Provider business mailing address

POB 7132960
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 815-740-1900
  • Fax: 815-729-3294
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number71069
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.127618
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036-127618
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036127618
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: