Provider Demographics
NPI:1427343938
Name:NASIR, SAIFULLAH (MD)
Entity type:Individual
Prefix:DR
First Name:SAIFULLAH
Middle Name:
Last Name:NASIR
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 1:1345 WILEY RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4356
Mailing Address - Country:US
Mailing Address - Phone:847-490-0060
Mailing Address - Fax:
Practice Address - Street 1:1345 WILEY RD STE 111
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4356
Practice Address - Country:US
Practice Address - Phone:847-490-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10041524207R00000X
IL036135245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine