Provider Demographics
NPI:1659722262
Name:ISHAQUE, SANDAL FAISAL (MD)
Entity Type:Individual
Prefix:
First Name:SANDAL
Middle Name:FAISAL
Last Name:ISHAQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDAL
Other - Middle Name:
Other - Last Name:KATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1372 BURNETT DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502
Mailing Address - Country:US
Mailing Address - Phone:630-397-1781
Mailing Address - Fax:
Practice Address - Street 1:1500 S CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608
Practice Address - Country:US
Practice Address - Phone:773-257-6552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125068142207R00000X
IL036150858207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine