Provider Demographics
NPI:1427259670
Name:HUSSAIN, NADEEM (MD)
Entity type:Individual
Prefix:DR
First Name:NADEEM
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-933-4056
Mailing Address - Fax:930-933-4057
Practice Address - Street 1:25 N WINFIELD ROAD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-933-4056
Practice Address - Fax:930-933-4057
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1172942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036117294Medicaid
IL363149833OtherTAX IDENTIFICAITON NUMBER
IL206147OtherMEDICARE GROUP NUMBER
IL3631498336019001OtherCDPG HFS PAYEE ID
ILP00651310OtherMEDICARE RAILROAD
IL0222075OtherBLUE CROSS GROUP NUMBER
ILP00651310OtherMEDICARE RAILROAD