Provider Demographics
NPI:1659805281
Name:UL HAQ, MOHAMMAD ADNAN (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD ADNAN
Middle Name:
Last Name:UL HAQ
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 1:1975 LIN LOR LN STE 295
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4964
Mailing Address - Country:US
Mailing Address - Phone:847-506-4400
Mailing Address - Fax:
Practice Address - Street 1:1975 LIN LOR LN STE 295
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4964
Practice Address - Country:US
Practice Address - Phone:847-506-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2021-10-01
Deactivation Date:2018-08-30
Deactivation Code:
Reactivation Date:2018-09-12
Provider Licenses
StateLicense IDTaxonomies
IL035157708207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program