Provider Demographics
NPI:1770648362
Name:ELADL, ASIM ELSAYED (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ASIM
Middle Name:ELSAYED
Last Name:ELADL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4366
Mailing Address - Country:US
Mailing Address - Phone:224-735-3522
Mailing Address - Fax:224-735-3523
Practice Address - Street 1:1925 E RAND RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4366
Practice Address - Country:US
Practice Address - Phone:224-735-3522
Practice Address - Fax:224-735-3523
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL070012122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL191676OtherUNITED HEALTHCARE
IL261QP2000XOtherPHYSICAL THERAPY