Healthcare Provider Details

I. General information

NPI: 1902965098
Provider Name (Legal Business Name): A M ARSHAD M D S C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 01/22/2024
Certification Date: 01/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 LAKEVIEW PKWY SUITE 192
VERNON HILLS IL
60061-1857
US

IV. Provider business mailing address

565 LAKEVIEW PKWY SUITE 192
VERNON HILLS IL
60061-1857
US

V. Phone/Fax

Practice location:
  • Phone: 847-658-4574
  • Fax:
Mailing address:
  • Phone: 847-658-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number036091755
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number036091755
License Number StateIL

VIII. Authorized Official

Name: ABRAR ARSHAD
Title or Position: OWNER
Credential: MD
Phone: 847-571-8293