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General NPI Number Information
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NPI Number | 1700993896
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Entity Type | Organization
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Legal Business Name | ANSARI MD LTD
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 623 W WASHINGTON ST
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City | PITTSFIELD
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State | IL
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Zip | 62363-1349
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Country | US
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Telephone | 217-285-4414
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Fax | 217-285-5600
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Provider Business Mailing Address
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Address Line | 623 W WASHINGTON ST
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City | PITTSFIELD
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State | IL
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Zip | 62363-1349
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Country | US
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Telephone | 217-285-4414
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Fax | 217-285-5600
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANSAR H ANSARI
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Credential | M.D.
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Telephone | 217-285-4414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | IL
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