Provider Demographics
NPI:1275526006
Name:SAHAR K RIDA MD SC
Entity Type:Organization
Organization Name:SAHAR K RIDA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAHAR
Authorized Official - Middle Name:K
Authorized Official - Last Name:RIDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-954-0112
Mailing Address - Street 1:380 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2290
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:SUITE 310
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:847-954-0112
Practice Address - Fax:847-954-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0001632139OtherBCBS
10672860OtherCAQH
D13814Medicare UPIN
IL208025Medicare ID - Type Unspecified