Provider Demographics
NPI:1336384460
Name:AKHTAR, MUHAMMAD S (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:S
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1302 FRANKLIN AVE STE 4500
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3593
Mailing Address - Country:US
Mailing Address - Phone:309-556-8300
Mailing Address - Fax:309-556-8392
Practice Address - Street 1:1302 FRANKLIN AVE STE 4500
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3593
Practice Address - Country:US
Practice Address - Phone:309-556-8300
Practice Address - Fax:309-556-8392
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272835207R00000X, 207RC0000X
WI65951-20207R00000X, 207RC0000X
IL036147874207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY272835OtherNYS LIC
IL036147874OtherIL LICENSE