Provider Demographics
NPI:1801968953
Name:ARSHAD, MUSSARAT (MD)
Entity type:Individual
Prefix:
First Name:MUSSARAT
Middle Name:
Last Name:ARSHAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SHEARWATER CT
Mailing Address - Street 2:
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-7523
Mailing Address - Country:US
Mailing Address - Phone:847-540-2321
Mailing Address - Fax:
Practice Address - Street 1:2575 W ALGONQUIN RD
Practice Address - Street 2:SUITE A
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-9403
Practice Address - Country:US
Practice Address - Phone:847-658-4403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336053897208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036092453Medicaid
IL201116Medicare PIN
IL036092453Medicaid
IL336053897OtherIL LICENCE