Provider Demographics
NPI:1407332679
Name:ISRAR, SHAZIA AFREEN (MD)
Entity Type:Individual
Prefix:
First Name:SHAZIA
Middle Name:AFREEN
Last Name:ISRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAZIA
Other - Middle Name:
Other - Last Name:AFREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-3269
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:181 FERNWOOD DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4525
Practice Address - Country:US
Practice Address - Phone:630-459-9191
Practice Address - Fax:630-759-9118
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64148207Q00000X
IL036-165562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine