Provider Demographics
NPI:1679687750
Name:SYED, SHAHWAR F (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAHWAR
Middle Name:F
Last Name:SYED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 W ALGONQUIN RD STE C
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-9409
Mailing Address - Country:US
Mailing Address - Phone:847-854-8595
Mailing Address - Fax:847-854-8599
Practice Address - Street 1:2575 W ALGONQUIN RD STE C
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-9409
Practice Address - Country:US
Practice Address - Phone:847-854-8595
Practice Address - Fax:847-854-8599
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360701314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0360701314Medicaid
IL0360701314Medicaid
ILL23048Medicare ID - Type Unspecified