Provider Demographics
NPI:1609934983
Name:ALAVI, NADEEM Z (DO)
Entity Type:Individual
Prefix:
First Name:NADEEM
Middle Name:Z
Last Name:ALAVI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:225 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4304
Practice Address - Country:US
Practice Address - Phone:847-941-7900
Practice Address - Fax:847-941-7902
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-116944207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036116944Medicaid
IL1620385OtherBLUE SHIELD
ILK33312Medicare PIN
IL036116944Medicaid
ILK33311Medicare PIN