Provider Demographics
NPI:1437143013
Name:RAHMAN, ADEEBUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEEBUR
Middle Name:
Last Name:RAHMAN
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 1:16650 HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1847
Mailing Address - Country:US
Mailing Address - Phone:708-342-3000
Mailing Address - Fax:708-343-3040
Practice Address - Street 1:16650 HARLEM AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1847
Practice Address - Country:US
Practice Address - Phone:708-342-3000
Practice Address - Fax:708-343-3040
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-084215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084215Medicaid
IL036084215Medicaid
ILF56558Medicare UPIN
ILP00235188Medicare ID - Type UnspecifiedRR MEDICARE NUMBER
363594874OtherEIN