Provider Demographics
NPI:1396829727
Name:AZIZ, NADER (MD)
Entity type:Individual
Prefix:DR
First Name:NADER
Middle Name:
Last Name:AZIZ
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 1:22285 N PEPPER RD STE 302
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2541
Mailing Address - Country:US
Mailing Address - Phone:847-726-0774
Mailing Address - Fax:847-277-1549
Practice Address - Street 1:22285 N PEPPER RD STE 302
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2541
Practice Address - Country:US
Practice Address - Phone:847-726-0774
Practice Address - Fax:847-277-1549
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0363978526207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084766Medicaid
IL036084766Medicaid