Provider Demographics
NPI:1265408694
Name:SALIK, SYED ZAFAR (MD)
Entity type:Individual
Prefix:MR
First Name:SYED
Middle Name:ZAFAR
Last Name:SALIK
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 1:231 RAPTOR COURT
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:IL
Mailing Address - Zip Code:62535-9674
Mailing Address - Country:US
Mailing Address - Phone:217-791-6703
Mailing Address - Fax:217-791-6976
Practice Address - Street 1:363 S. MAIN STREET
Practice Address - Street 2:SUITE 345
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62523-1412
Practice Address - Country:US
Practice Address - Phone:217-791-6703
Practice Address - Fax:217-791-6976
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-26
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230554207RI0200X, 2084P0800X
IL036.12223207RI0200X, 2084P0800X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.122223Medicaid
NY02595233Medicaid
NY02595233Medicaid
NYI20254Medicare UPIN
NY454BX1Medicare ID - Type Unspecified