Individual provider · NPI-1

Nadeem Ansari, MD

Internal Medicine · Bourbonnais, IL

NPI number1073651808
StatusActive
Last updated in NPPESJan 11, 2021

Details

NPI
1073651808
Entity type
Individual (NPI-1)
Name
Nadeem Ansari
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Feb 2, 2007
Certification date
Jan 11, 2021
Last updated
Jan 11, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine036-071794ILYes

Practice location

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004

Phone 815-935-2784 · Fax 815-935-5687

Mailing address

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004

Phone 815-935-2784 · Fax 815-935-5687

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