Provider Demographics
NPI:1083719991
Name:AKHTER, IQBAL M (MD)
Entity Type:Individual
Prefix:DR
First Name:IQBAL
Middle Name:M
Last Name:AKHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1007 SOUTH 42ND ST.
Mailing Address - Street 2:BLDG. A STE. 4
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864
Mailing Address - Country:US
Mailing Address - Phone:618-242-4626
Mailing Address - Fax:618-242-4638
Practice Address - Street 1:1007 S.42ND ST.
Practice Address - Street 2:BLDG A STE. 4
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864
Practice Address - Country:US
Practice Address - Phone:618-242-4626
Practice Address - Fax:618-242-4638
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2014-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036087371207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087371Medicaid
IL036087371Medicaid
ILG11314Medicare UPIN