Provider Demographics
NPI:1801417217
Name:QADRI, FATIMA ASFIA (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:ASFIA
Last Name:QADRI
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 1:7645 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-2656
Mailing Address - Country:US
Mailing Address - Phone:630-386-3302
Mailing Address - Fax:
Practice Address - Street 1:200 N GARY AVE
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-1834
Practice Address - Country:US
Practice Address - Phone:630-360-2958
Practice Address - Fax:630-360-2959
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036167449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program