Provider Demographics
NPI:1922173608
Name:ALGAYED, ILHAM A
Entity Type:Individual
Prefix:
First Name:ILHAM
Middle Name:A
Last Name:ALGAYED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:190 WAUKEGAN RD STE B
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5655
Practice Address - Country:US
Practice Address - Phone:847-945-4575
Practice Address - Fax:847-945-4593
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087463208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1620385OtherBLUE SHIELD
IL036087463Medicaid
IL1620385OtherBLUE SHIELD
F86573Medicare UPIN
IL581060Medicare PIN