Provider Demographics
NPI:1629194543
Name:HASHMI, NASHIB (MD)
Entity Type:Individual
Prefix:DR
First Name:NASHIB
Middle Name:
Last Name:HASHMI
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 1:401 N WALL ST
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-110874207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110874Medicaid
IL04632050OtherBLUECROSSBLUESHIELD
ILG32805Medicare UPIN
IL209865Medicare ID - Type Unspecified