Provider Demographics
NPI:1477622819
Name:ANWAR, SYED H (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:H
Last Name:ANWAR
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 1:2050 LARKIN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123
Mailing Address - Country:US
Mailing Address - Phone:847-697-2400
Mailing Address - Fax:847-697-2438
Practice Address - Street 1:2050 LARKIN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-697-2400
Practice Address - Fax:847-697-2438
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360769562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076956Medicaid
3535390OtherECFMG
3535390OtherECFMG
ILL22191Medicare ID - Type Unspecified