Healthcare Provider Details

I. General information

NPI: 1194802850
Provider Name (Legal Business Name): SHAHID S SARWAR MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 S. ELMHURST RD
MOUNT PROSPECT IL
60056-5805
US

IV. Provider business mailing address

2380 S. ELMHURST RD
MOUNT PROSPECT IL
60056-5805
US

V. Phone/Fax

Practice location:
  • Phone: 847-228-5557
  • Fax: 847-228-6526
Mailing address:
  • Phone: 847-228-5557
  • Fax: 847-228-6526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number36-066455
License Number StateIL

VIII. Authorized Official

Name: DR. SHAHID S SARWAR
Title or Position: OWNER
Credential: M.D.
Phone: 847-228-5557