Provider Demographics
NPI:1639251663
Name:ASADULLAH, MUHAMMAD (DC)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
Last Name:ASADULLAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 MANNING RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4309
Mailing Address - Country:US
Mailing Address - Phone:630-330-1818
Mailing Address - Fax:
Practice Address - Street 1:1921 MANNING RD
Practice Address - Street 2:SUITE 200
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4309
Practice Address - Country:US
Practice Address - Phone:630-330-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008697111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL038-008697Medicaid
IL547940OtherPTAN
IL547940OtherPTAN