MEDICARE: HAIDER MEDICAL GROUP, LTD

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	207R00000X	Internal Medicine Physician	036100063	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1538254693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAIDER MEDICAL GROUP, LTD

Provider Business Mailing Address
First Line	:	PO BOX 2036
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60039-2036
Country	:	US
Telephone Number	:	815-788-0468
Fax Number	:	815-788-0489

Provider Business Practice Location Address
First Line	:	5911 NORTHWEST HWY
Second Line	:	SUITE 101
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-8065
Country	:	US
Telephone Number	:	815-788-0468
Fax Number	:	815-788-0489

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SYED WASEEM HAIDER
Credential	:	M.D.
Telephone Number	:	815-788-0468

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/14/2011

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Directions to “HAIDER MEDICAL GROUP, LTD ” Practice Location

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