Provider Demographics
NPI:1932953759
Name:NAQVI, MUKHTAR HUSSAIN
Entity Type:Individual
Prefix:
First Name:MUKHTAR
Middle Name:HUSSAIN
Last Name:NAQVI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 CAPSTAN DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1006
Mailing Address - Country:US
Mailing Address - Phone:773-441-6913
Mailing Address - Fax:
Practice Address - Street 1:7010 CHAD COLLEY BLVD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-6034
Practice Address - Country:US
Practice Address - Phone:479-308-2243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program