Provider Demographics
NPI:1972815033
Name:QADRI, MUNEEB (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNEEB
Middle Name:
Last Name:QADRI
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 1:601 SOUTH BLVD APT F
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2942
Mailing Address - Country:US
Mailing Address - Phone:631-988-4155
Mailing Address - Fax:
Practice Address - Street 1:601 SOUTH BLVD APT F
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2942
Practice Address - Country:US
Practice Address - Phone:631-988-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.131348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine