MEDICARE: DR. ZAFAR QUADER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	109425	MO
2	207RG0100X	Gastroenterology Physician	036-082132	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110144176	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124013636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZAFAR QUADER M.D.

Provider Business Mailing Address
First Line	:	751 N RUTLEDGE ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-4968
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-4485

Provider Business Practice Location Address
First Line	:	751 N RUTLEDGE ST STE 1100
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62702-4968
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-4485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/21/2022

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Directions to “ DR. ZAFAR QUADER M.D.” Practice Location

Language	Start Address	Practice Location

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