Provider Demographics
NPI:1215005822
Name:HUSAIN, SARWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SARWAR
Middle Name:
Last Name:HUSAIN
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 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-763-3808
Mailing Address - Fax:773-774-3739
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-763-3808
Practice Address - Fax:773-774-3739
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036081914Medicaid
IL036081914Medicaid
IL577930Medicare PIN