Provider Demographics
NPI:1639128432
Name:ANWAR, ABDEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDEL
Middle Name:
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 1:911 N ELM ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:630-856-6865
Mailing Address - Fax:630-856-6813
Practice Address - Street 1:321 E HARRIS ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1629
Practice Address - Country:US
Practice Address - Phone:517-541-5927
Practice Address - Fax:517-543-0875
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36067064207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE22457Medicare UPIN