Provider Demographics
NPI:1649002304
Name:ASADULLAH, MALIHA (OD)
Entity type:Individual
Prefix:DR
First Name:MALIHA
Middle Name:
Last Name:ASADULLAH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13181 W HUNT MASTER LN
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8168
Mailing Address - Country:US
Mailing Address - Phone:630-470-3671
Mailing Address - Fax:
Practice Address - Street 1:9400 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2326
Practice Address - Country:US
Practice Address - Phone:708-598-1322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist