Healthcare Provider Details

I. General information

NPI: 1013950476
Provider Name (Legal Business Name): ASAD JAMAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N JACKSON ST
MORRISON IL
61270-3042
US

IV. Provider business mailing address

303 N JACKSON ST
MORRISON IL
61270-3042
US

V. Phone/Fax

Practice location:
  • Phone: 815-772-4003
  • Fax:
Mailing address:
  • Phone: 815-772-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-114596
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036114596
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036114596
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: