Healthcare Provider Details

I. General information

NPI: 1114129921
Provider Name (Legal Business Name): ABID KHALID NAZEER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HARGER RD STE 200
OAK BROOK IL
60523-1816
US

IV. Provider business mailing address

1200 HARGER RD STE 200
OAK BROOK IL
60523-1816
US

V. Phone/Fax

Practice location:
  • Phone: 630-607-0387
  • Fax: 630-385-0290
Mailing address:
  • Phone: 630-607-0387
  • Fax: 630-385-0290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number036128069
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.128069
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: