Provider Demographics
NPI:1780870410
Name:ALAM S. MD, LLC
Entity type:Organization
Organization Name:ALAM S. MD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAROOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-552-8826
Mailing Address - Street 1:ALAM S MD LLC
Mailing Address - Street 2:PO BOX 606
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-0606
Mailing Address - Country:US
Mailing Address - Phone:630-552-8826
Mailing Address - Fax:630-552-0236
Practice Address - Street 1:1200 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:IL
Practice Address - Zip Code:60545-1790
Practice Address - Country:US
Practice Address - Phone:630-552-8826
Practice Address - Fax:630-552-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213435Medicare PIN