Provider Demographics
NPI:1528022738
Name:NASHIB HASHMI MD PC
Entity Type:Organization
Organization Name:NASHIB HASHMI MD PC
Other - Org Name:KIDNEY CENTER OF KANKAKEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN NEPHROLOGIST PRESIDENT CO
Authorized Official - Prefix:DR
Authorized Official - First Name:NASHIB
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-932-7110
Mailing Address - Street 1:401 N WALL ST
Mailing Address - Street 2:STE 100
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-2934
Mailing Address - Country:US
Mailing Address - Phone:815-932-7110
Mailing Address - Fax:815-932-7112
Practice Address - Street 1:401 N WALL ST
Practice Address - Street 2:STE 100
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2934
Practice Address - Country:US
Practice Address - Phone:815-932-7110
Practice Address - Fax:815-932-7112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
04632050OtherBLUE CROSS BLUE SHIELD
G32805Medicare UPIN
04632050OtherBLUE CROSS BLUE SHIELD