Provider Demographics
NPI:1467475848
Name:KHURSHID, ABID (MD)
Entity Type:Individual
Prefix:DR
First Name:ABID
Middle Name:
Last Name:KHURSHID
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 1:2500 S HIGHLAND
Mailing Address - Street 2:SUITE 325
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2264
Mailing Address - Country:US
Mailing Address - Phone:630-495-9810
Mailing Address - Fax:630-495-9825
Practice Address - Street 1:2500 S HIGHLAND AVE
Practice Address - Street 2:SUITE 325
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5363
Practice Address - Country:US
Practice Address - Phone:630-495-9810
Practice Address - Fax:630-495-9825
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083926207RP1001X
IL063-083926207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083926Medicaid
ILG09304Medicare UPIN
IL210301Medicare ID - Type Unspecified