Healthcare Provider Details

I. General information

NPI: 1447416342
Provider Name (Legal Business Name): MUHAMMAD FAROOQ ASGHAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 CROSS ST STE 2114
SHILOH IL
62269-2988
US

IV. Provider business mailing address

1404 CROSS ST STE 2114
SHILOH IL
62269-2988
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-2220
  • Fax: 618-233-2555
Mailing address:
  • Phone: 618-233-2220
  • Fax: 618-233-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036125732
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-125732
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: