Provider Demographics
NPI:1750014395
Name:ANAS SOHAIL, ANAS (MD)
Entity Type:Individual
Prefix:
First Name:ANAS
Middle Name:
Last Name:ANAS SOHAIL
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 1:1300 FRANKLIN AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3799
Mailing Address - Country:US
Mailing Address - Phone:309-268-3558
Mailing Address - Fax:309-268-3713
Practice Address - Street 1:1300 FRANKLIN AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3799
Practice Address - Country:US
Practice Address - Phone:309-268-3558
Practice Address - Fax:309-268-3713
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2023-07-20
Deactivation Date:2023-03-13
Deactivation Code:
Reactivation Date:2023-07-20
Provider Licenses
StateLicense IDTaxonomies
IL125.080111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine