Healthcare Provider Details

I. General information

NPI: 1285884403
Provider Name (Legal Business Name): ALI MINHAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2008
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N ORCHARD DR BLDG 18
PARK FOREST IL
60466-1200
US

IV. Provider business mailing address

114 N ORCHARD DR BLDG 18
PARK FOREST IL
60466-1200
US

V. Phone/Fax

Practice location:
  • Phone: 708-283-3000
  • Fax:
Mailing address:
  • Phone: 630-484-0804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036128694
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57059
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.128694
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.141208
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: