Provider Demographics
NPI:1689660995
Name:IMDAD, ZARQA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ZARQA
Middle Name:
Last Name:IMDAD
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 1:901 MCCLINTOCK DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0872
Mailing Address - Country:US
Mailing Address - Phone:888-220-6432
Mailing Address - Fax:630-654-4253
Practice Address - Street 1:2130 POINT BLVD
Practice Address - Street 2:STE 900
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9215
Practice Address - Country:US
Practice Address - Phone:888-220-6432
Practice Address - Fax:847-608-9154
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-110212207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-110-212Medicaid
ILG99477Medicare UPIN
ILK02366Medicare PIN
IL036-110-212Medicaid
ILK02364Medicare PIN