Provider Demographics
NPI:1487675187
Name:ANWAR MEDICAL CENTER OF SOUTHWEST SUBURB SC
Entity Type:Organization
Organization Name:ANWAR MEDICAL CENTER OF SOUTHWEST SUBURB SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:U
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-834-1903
Mailing Address - Street 1:PO BOX 9594
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-0594
Mailing Address - Country:US
Mailing Address - Phone:815-436-6814
Mailing Address - Fax:815-834-1942
Practice Address - Street 1:300 READ ST
Practice Address - Street 2:SUITE B
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-3265
Practice Address - Country:US
Practice Address - Phone:815-834-1903
Practice Address - Fax:815-834-1942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9928222OtherBCBS
IL9928222OtherBCBS
IL200303Medicare PIN