Provider Demographics
NPI:1164402335
Name:ROHAIL, HUMA Q (MD)
Entity Type:Individual
Prefix:DR
First Name:HUMA
Middle Name:Q
Last Name:ROHAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 22ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-517-5120
Mailing Address - Fax:
Practice Address - Street 1:396 REMINGTON BLVD STE 140
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4311
Practice Address - Country:US
Practice Address - Phone:630-495-9356
Practice Address - Fax:630-495-9357
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090858207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090858Medicaid
L60706Medicare UPIN
K19871Medicare ID - Type Unspecified