Provider Demographics
NPI:1265434815
Name:DALAL, RASHID AHMED (MD)
Entity type:Individual
Prefix:DR
First Name:RASHID
Middle Name:AHMED
Last Name:DALAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7 BEAVER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5497
Mailing Address - Country:US
Mailing Address - Phone:618-239-9500
Mailing Address - Fax:618-239-9555
Practice Address - Street 1:5003 N ILLINOIS ST STE 1
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-3419
Practice Address - Country:US
Practice Address - Phone:618-239-9500
Practice Address - Fax:618-239-9555
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD103192207RN0300X
IL036090043207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
286639OtherHEALTHLINK PPO HMO WC
IL8226186OtherBCBS
IL036090043Medicaid
110184061OtherRR MEDICARE
110483OtherBCBS CHOICE
MO203771902Medicaid
38137OtherGHP SENSICARE ACCESS, CMR
2369786OtherAETNA PRUDENTIAL
3100008 NEPHOtherUNITED HEALTHCARE
MO816M2OtherBCBS ALLIANCE
MO000094127Medicare PIN
110483OtherBCBS CHOICE
3100008 NEPHOtherUNITED HEALTHCARE
IL036090043Medicaid