Provider Demographics
NPI:1235233792
Name:ALA, SYED M (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:M
Last Name:ALA
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 1:2815 LOBELIA CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4964
Mailing Address - Country:US
Mailing Address - Phone:847-736-9340
Mailing Address - Fax:
Practice Address - Street 1:1100 E NORRIS DR
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1604
Practice Address - Country:US
Practice Address - Phone:815-433-3100
Practice Address - Fax:815-431-5672
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35120053207RI0200X
IL036110025207RI0200X, 208M00000X
WI51938-20207RI0200X
IN01058364A208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0072220Medicaid
OH0072220Medicaid
ILH23998Medicare UPIN
WI02120-2126Medicare PIN
OHH160111Medicare PIN