Provider Demographics
NPI:1033107685
Name:SHAHZAD, MUHAMMAD A (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:A
Last Name:SHAHZAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOUTH 376 SUMMIT AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2604
Mailing Address - Country:US
Mailing Address - Phone:630-822-9009
Mailing Address - Fax:630-953-9339
Practice Address - Street 1:1 SOUTH 376 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-993-5402
Practice Address - Fax:630-953-9339
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095761207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095761Medicaid
G54620Medicare UPIN
IL036095761Medicaid