Provider Demographics
NPI:1295466183
Name:ANWAR, MUHAMMAD TAYYAB (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD TAYYAB
Middle Name:
Last Name:ANWAR
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 1:1950 W. POLK STREET 6TH FLOOR #142
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-864-7311
Mailing Address - Fax:312-864-9725
Practice Address - Street 1:1950 W. POLK STREET 6TH FLOOR #142
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-7311
Practice Address - Fax:312-864-9725
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125079524207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine