Provider Demographics
NPI:1831270909
Name:AZAD, NASRIN (MD)
Entity type:Individual
Prefix:
First Name:NASRIN
Middle Name:
Last Name:AZAD
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 1:23723 N ELM RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2201
Mailing Address - Country:US
Mailing Address - Phone:847-634-9464
Mailing Address - Fax:708-202-7078
Practice Address - Street 1:HINES VA HOSPITAL ROOSEVELT AND 5TH AVE
Practice Address - Street 2:1422
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-5430
Practice Address - Fax:708-202-7078
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism