Provider Demographics
NPI:1912997933
Name:AKHTAR, NAVEED (MD)
Entity type:Individual
Prefix:DR
First Name:NAVEED
Middle Name:
Last Name:AKHTAR
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 1:18 KINGSBURY CT
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1721
Mailing Address - Country:US
Mailing Address - Phone:630-920-1703
Mailing Address - Fax:
Practice Address - Street 1:402 W BOUGHTON RD
Practice Address - Street 2:SUITE F-1
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1872
Practice Address - Country:US
Practice Address - Phone:630-378-4014
Practice Address - Fax:630-378-4784
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-077398207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036077398Medicaid
IL203670Medicare ID - Type Unspecified
IL036077398Medicaid