Provider Demographics
NPI:1225141005
Name:KYSIA, RASHID FUAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RASHID
Middle Name:FUAD
Last Name:KYSIA
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 1:5324 S HYDE PARK BLVD
Mailing Address - Street 2:APT #3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5713
Mailing Address - Country:US
Mailing Address - Phone:773-572-8672
Mailing Address - Fax:
Practice Address - Street 1:5324 S HYDE PARK BLVD
Practice Address - Street 2:APT #3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-5713
Practice Address - Country:US
Practice Address - Phone:773-633-8942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-113-214207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
R01828Medicare PIN