Provider Demographics
NPI:1437110970
Name:HUSSAINI, ASIMA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ASIMA
Middle Name:K
Last Name:HUSSAINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RIVERSIDE DR STE 2800
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-5004
Mailing Address - Country:US
Mailing Address - Phone:815-935-1100
Mailing Address - Fax:815-937-5966
Practice Address - Street 1:400 RIVERSIDE DR STE 2800
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-5004
Practice Address - Country:US
Practice Address - Phone:815-935-1100
Practice Address - Fax:815-937-5966
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108934207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108934Medicaid
IL4632039OtherBC
ILK38143Medicare PIN
H94632Medicare UPIN