Provider Demographics
NPI:1437167541
Name:ISKANDER, ASHRAF A (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHRAF
Middle Name:A
Last Name:ISKANDER
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 1:2320 S ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-7756
Mailing Address - Country:US
Mailing Address - Phone:815-609-9480
Mailing Address - Fax:815-609-9482
Practice Address - Street 1:2320 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-7756
Practice Address - Country:US
Practice Address - Phone:815-609-9480
Practice Address - Fax:815-609-9482
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094077207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094077Medicaid
IL036094077Medicaid
G81406Medicare UPIN