Provider Demographics
NPI:1407877160
Name:AKHTAR, RIAZ A (MD)
Entity Type:Individual
Prefix:DR
First Name:RIAZ
Middle Name:A
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RIAZ
Other - Middle Name:A
Other - Last Name:AKHTAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1S085 SUMMIT AVE
Mailing Address - Street 2:CARDIO MEDICAL CENTER
Mailing Address - City:OAK BROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-629-6700
Mailing Address - Fax:630-629-1888
Practice Address - Street 1:1S085 SUMMIT AVE
Practice Address - Street 2:CARDIO MEDICAL CENTER
Practice Address - City:OAK BROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-629-6700
Practice Address - Fax:630-629-1888
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1L00336477611207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036047761Medicaid
IL222050222051Medicare ID - Type Unspecified
IL036047761Medicaid