Provider Demographics
NPI:1275715351
Name:ABDUL QADIR, MD, P.C.
Entity Type:Organization
Organization Name:ABDUL QADIR, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:QADIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-301-7366
Mailing Address - Street 1:1177 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-2281
Mailing Address - Country:US
Mailing Address - Phone:630-301-7366
Mailing Address - Fax:630-301-7369
Practice Address - Street 1:1177 N HIGHLAND AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2281
Practice Address - Country:US
Practice Address - Phone:630-301-7366
Practice Address - Fax:630-301-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036092190Medicaid
IL208899Medicare PIN
ILG59275Medicare UPIN