Provider Demographics
NPI:1841307931
Name:HAQ, ANWAR UL (BS)
Entity type:Individual
Prefix:MR
First Name:ANWAR
Middle Name:UL
Last Name:HAQ
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 KEELER AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3603
Mailing Address - Country:US
Mailing Address - Phone:847-329-9917
Mailing Address - Fax:847-329-9918
Practice Address - Street 1:7733 KEELER AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3603
Practice Address - Country:US
Practice Address - Phone:847-329-9917
Practice Address - Fax:847-329-9918
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01636089OtherBC &BS PROVIDER ID
11527979OtherAETNA INSURANCE
IL01636089OtherBC &BS PROVIDER ID