Provider Demographics
NPI:1922101559
Name:ANSARI, NAVEED ZAFAR (MD)
Entity Type:Individual
Prefix:MR
First Name:NAVEED
Middle Name:ZAFAR
Last Name:ANSARI
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 1:1100 W CENTRAL RD
Mailing Address - Street 2:STE 205
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005
Mailing Address - Country:US
Mailing Address - Phone:847-253-4040
Mailing Address - Fax:847-253-4700
Practice Address - Street 1:1100 W CENTRAL RD
Practice Address - Street 2:STE 205
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005
Practice Address - Country:US
Practice Address - Phone:847-253-4040
Practice Address - Fax:847-253-4700
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103463207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103463Medicaid
IL01623492OtherBCBS
IL571890Medicare ID - Type UnspecifiedGROUP
ILK25121Medicare PIN
IL01623492OtherBCBS