Provider Demographics
NPI:1073997037
Name:QURAISHI, HANZLA HASAN (MD)
Entity Type:Individual
Prefix:
First Name:HANZLA
Middle Name:HASAN
Last Name:QURAISHI
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 1:1S450 SUMMIT AVE STE 165
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3952
Mailing Address - Country:US
Mailing Address - Phone:630-320-6871
Mailing Address - Fax:630-385-0026
Practice Address - Street 1:1S450 SUMMIT AVE STE 165
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3952
Practice Address - Country:US
Practice Address - Phone:630-468-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99097279A208100000X
IL036148198208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation